Stroke, Vol 23, 1056-1061, Copyright © 1992 by American Heart Association
K Toyoda, M Yasaka, S Nagata and T Yamaguchi
BACKGROUND AND PURPOSE: We studied the frequency and grade of
atherosclerotic changes in the thoracic aorta and their significance as
embologenic lesions in patients with stroke. METHODS: Using transesophageal
echocardiography, we evaluated complicated lesions in the thoracic aortas
of 62 patients who met our clinical criteria for embolic stroke. A
complicated lesion was defined as a raised lesion with an irregular surface
or acoustic shadow based on a comparative study of echocardiographic and
histopathologic findings. The results were compared with plain radiographic
findings and in some cases with computed tomographic or aortographic
findings. RESULTS: Twenty-six patients (42%) showed complicated aortic arch
lesions on echocardiogram. Transesophageal echocardiography brought us more
abundant information than other techniques. Aortic knob calcification by
plain radiography correlated well with the presence of
echocardiographically complicated lesions, suggesting its utility for rough
screening of atherosclerotic changes. Fifty-two patients had other
potential embolic sources in the heart or cervical arteries. Among the
remaining 10 patients without extra-aortic embolic sources, three showed
complicated lesions and were diagnosed as having aortogenic embolic stroke.
CONCLUSIONS: Aortic atherosclerosis should be recognized as an embolic
source of stroke and the advantage of transesophageal echocardiography
recognized in its evaluation.
ARTICLES
Aortogenic embolic stroke: a transesophageal echocardiographic approach
Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan.
This article has been cited by other articles:
 |
|
 |
|
  Y. Ueno, K. Kimura, Y. Iguchi, K. Shibazaki, T. Inoue, N. Hattori, and T. Urabe Mobile Aortic Plaques Are a Cause of Multiple Brain Infarcts Seen on Diffusion-Weighted Imaging Stroke, September 1, 2007; 38(9): 2470 - 2476. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Hueb, S. G. Zanati, K. Okoshi, C. N. Raffin, L. V. de Arruda Silveira, and B. B. Matsubara Association Between Atherosclerotic Aortic Plaques and Left Ventricular Hypertrophy in Patients With Cerebrovascular Events Stroke, April 1, 2006; 37(4): 958 - 962. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Saito, H. Moriwaki, H. Oe, K. Miyashita, K. Nagatsuka, S. Ueno, and H. Naritomi Mechanisms of Bihemispheric Brain Infarctions in the Anterior Circulation on Diffusion-Weighted Images AJNR Am. J. Neuroradiol., April 1, 2005; 26(4): 809 - 814. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Fujimoto, M. Yasaka, R. Otsubo, H. Oe, K. Nagatsuka, and K. Minematsu Aortic Arch Atherosclerotic Lesions and the Recurrence of Ischemic Stroke Stroke, June 1, 2004; 35(6): 1426 - 1429. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Yonemura, K. Kimura, K. Minematsu, M. Uchino, and T. Yamaguchi Small Centrum Ovale Infarcts on Diffusion-Weighted Magnetic Resonance Imaging Stroke, June 1, 2002; 33(6): 1541 - 1544. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kimura, K. Minematsu, M. Koga, R. Arakawa, M. Yasaka, H. Yamagami, K. Nagatsuka, H. Naritomi, and T. Yamaguchi Microembolic Signals and Diffusion-weighted MR Imaging Abnormalities in Acute Ischemic Stroke AJNR Am. J. Neuroradiol., June 1, 2001; 22(6): 1037 - 1042. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Mizuno, M. Toyama, N. Tabuchi, K. Kuriu, S. Ozaki, I. Kawase, and H. Horimi Thickened intima of the aortic arch is a risk factor for stroke with coronary artery bypass grafting Ann. Thorac. Surg., November 1, 2000; 70(5): 1565 - 1570. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Di Tullio, R. L. Sacco, M. T. Savoia, R. R. Sciacca, and S. Homma Gender Differences in the Risk of Ischemic Stroke Associated With Aortic Atheromas Stroke, November 1, 2000; 31(11): 2623 - 2627. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Tunick, G. A. Krinsky, V. S. Lee, and I. Kronzon Diagnostic Imaging of Thoracic Aortic Atherosclerosis Am. J. Roentgenol., April 1, 2000; 174(4): 1119 - 1125. [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Tunick and I. Kronzon Atheromas of the thoracic aorta: clinical and therapeutic update J. Am. Coll. Cardiol., March 1, 2000; 35(3): 545 - 554. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. J. Willens and K. M. Kessler Transesophageal Echocardiography in the Diagnosis of Diseases of the Thoracic Aorta* : Part II--Atherosclerotic and Traumatic Diseases of the Aorta Chest, January 1, 2000; 117(1): 233 - 243. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Weinberger, N. Papamitsakis, A. Newfield, J. Godbold, and M. Goldman Plaque Morphology Correlates With Cerebrovascular Symptoms in Patients With Complex Aortic Arch Plaque Arch Neurol, January 1, 2000; 57(1): 81 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Rundek, M. R. Di Tullio, R. R. Sciacca, I. V. Titova, J. P. Mohr, S. Homma, and R. L. Sacco Association Between Large Aortic Arch Atheromas and High-Intensity Transient Signals in Elderly Stroke Patients Stroke, December 1, 1999; 30(12): 2683 - 2686. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Eagle, R. A. Guyton, R. Davidoff, G. A. Ewy, J. Fonger, T. J. Gardner, J. P. Gott, H. C. Herrmann, R. A. Marlow, W. C. Nugent, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/ American Heart Association task force on Practice Guidelines (Committee to revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery) J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1262 - 1347. [Full Text] [PDF]
|
|
|
|
|
|
J. L. Blackshear, L. A. Pearce, R. G. Hart, M. Zabalgoitia, A. Labovitz, R. W. Asinger, and J. L. Halperin Aortic Plaque in Atrial Fibrillation : Prevalence, Predictors, and Thromboembolic Implications Stroke, April 1, 1999; 30(4): 834 - 840. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Keeley and C. Grines Scraping of aortic debris by coronary guiding catheters: A prospective evaluation of 1,000 cases J. Am. Coll. Cardiol., December 1, 1998; 32(7): 1861 - 1865. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Weinberger, S. Azhar, F. Danisi, R. Hayes, and M. Goldman A New Noninvasive Technique for Imaging Atherosclerotic Plaque in the Aortic Arch of Stroke Patients by Transcutaneous Real-Time B-Mode Ultrasonography : An Initial Report Stroke, March 1, 1998; 29(3): 673 - 676. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Cohen, C. Tzourio, B. Bertrand, C. Chauvel, M.-G. Bousser, and P. Amarenco Aortic Plaque Morphology and Vascular Events : A Follow-up Study in Patients With Ischemic Stroke Circulation, December 2, 1997; 96(11): 3838 - 3841. [Abstract] [Full Text]
|
|
|
|
 |
|
 L. Shore-Lesserson and S. N. Konstadt Aortic Atherosclerosis: Should We Bother to Look for It? Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1997; 1(1): 39 - 48. [PDF]
|
|
|
|
|
|
C. Stollberger, R. Seitelberger, C. Fenninger, C. Prainer, and J. Slany Aneurysm of the Left Sinus of Valsalva: An Unusual Source of Cerebral Embolism Stroke, August 1, 1996; 27(8): 1424 - 1426. [Abstract] [Full Text]
|
|
|
|
 |
|
 The French Study of Aortic Plaques in Stroke Group Atherosclerotic Disease of the Aortic Arch as a Risk Factor for Recurrent Ischemic Stroke N. Engl. J. Med., May 9, 1996; 334(19): 1216 - 1221. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Amarenco, A. Cohen, C. Tzourio, B. Bertrand, M. Hommel, G. Besson, C. Chauvel, P.-J. Touboul, and M.-G. Bousser Atherosclerotic Disease of the Aortic Arch and the Risk of Ischemic Stroke N. Engl. J. Med., December 1, 1994; 331(22): 1474 - 1479. [Abstract] [Full Text]
|
|