Transesophageal echocardiographic detection of aortic arch disease in patients with cerebral infarction.
- 1 July 1992
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 23 (7), 1005-1009
- https://doi.org/10.1161/01.str.23.7.1005
Abstract
Ulcerated plaques in the aortic arch are frequent autopsy findings in patients with cerebral infarctions, particularly those of unknown cause. It has been suggested that they could be a source of cerebral emboli. Using transesophageal echocardiography, we prospectively studied 12 consecutive patients with cerebral infarction of undetermined cause after noninvasive workup to evaluate the frequency of aortic plaques or mural thrombi that could embolize in cerebral arteries. Six patients (50%) had an intraluminal echogenic mass of the aortic arch, mainly located at the junction of the ascending aorta and arch. This material was pedunculated (in one patient) or broad based (in five patients) with a markedly irregular surface and intraluminal extension from 3 to 15 mm. In addition, we found cholesterol emboli in two of the four patients who underwent quadriceps biopsy. These results show that transesophageal echocardiography has capabilities in detecting such lesions and point to the aortic arch as a possible source of cerebral emboli in patients with cerebral infarction of unknown cause.Keywords
This publication has 12 references indexed in Scilit:
- The Prevalence of Ulcerated Plaques in the Aortic Arch in Patients with StrokeNew England Journal of Medicine, 1992
- Protruding Atheromas in the Thoracic Aorta and Systemic EmbolizationAnnals of Internal Medicine, 1991
- Recognition and embolic potential of intraaortic atherosclerotic debrisJournal of the American College of Cardiology, 1991
- Protruding atherosclerotic plaque in the aortic arch of patients with systemic embolization: A new finding seen by transesophageal echocardiographyAmerican Heart Journal, 1990
- Intraoperative Ultrasonic Imaging of the Ascending AortaThe Annals of Thoracic Surgery, 1989
- Infarcts of undetermined cause: The NINCDS stroke data bankAnnals of Neurology, 1989
- Unusual cause of recurrent arterial embolism: floating thrombus in the aortic arch surgically removed under hypothermic cardiocirculatory arrestEuropean Journal of Cardio-Thoracic Surgery, 1988
- Stroke Following Coronary Artery Bypass Grafting: A Ten-Year StudyThe Annals of Thoracic Surgery, 1985
- Cholesterol emboli in cerebral arteries as a complication of retrograde aortic perfusion during cardiac surgeryNeurology, 1970
- ATHEROSCLEROSIS OF THE CAROTID AND VERTEBRAL ARTERIES—EXTRACRANIAL AND INTRACRANIALJournal of Neuropathology and Experimental Neurology, 1965