Scientific PapersMobile atheroma of the aortic arch and the risk of carotid artery disease
Section snippets
Methods
Between March 1994 and July 1998, 40 patients with mobile atheromas by transesophageal echocardiography were studied to determine the incidence of significant carotid artery disease (70% or greater stenosis). All patients were captured prospectively in a vascular registry and were retrospectively reviewed. Patients with mobile atheromas and evidence of embolization were identified and both inpatient and outpatient records analyzed in detail. Specifically studied were age, gender, site of
Results
Forty patients with mobile atheromas of the thoracic aorta were diagnosed with transesophageal echocardiography. All 40 patients had evidence of embolization (Table). Patient age ranged from 57 to 73 years (mean 68.4). There were 22 men and 18 women in the study. Twenty of 40 (50%) patients presented with symptoms of TIA. Eleven of 40 (28%) patients presented with diffuse atheroembolization (lower extremity embolization and renal insufficiency). Six of 40 (15%) patients presented with a
Comments
The efficacy of carotid endarterectomy for asymptomatic carotid stenosis has found that surgery reduces the subsequent incidence of ipsilateral neurologic events. However, there was no effect on the overall incidence of stroke and death because nearly a quarter of neurologic events in patients treated with carotid stenosis developed on the side contralateral to that of the carotid lesion.12 Therefore, a number of the neurologic events in these patients could have developed as a result of an
References (15)
- et al.
Recognition and embolic potential of intraaortic athersclerotic debris
J Am Coll Cardiol
(1991) - et al.
Surgical implications of transesophageal echocardiography to grade the atheromatous aortic arch
Ann Thorac Surg
(1992) - et al.
Superiority of transesophageal echocardiography in detecting aortic arch atheromatous diseaseidentification of patients at increased risk of stroke during cardiac surgery
J Cardiothorac Vasc Anesth
(1994) - et al.
High risk for vascular events in patients with protruding aortic atheromasa prospective study
J Am Coll Card
(1994) - et al.
Mobile atheroma of the aortic arch is an underestimated source of embolization
Am J Surg
(1997) - et al.
Recurrent systemic embolization caused by aortic thrombi
Ann Thorac Surg
(1994) - et al.
Protruding aortic atheromas predict stroke in elderly patients undergoing cardiopulmonary bypassexperience with intraoperative transesophageal echocardiography
J Am Coll Card
(1992)