Aortic arch atheroma

International Journal of Stroke : Official Journal of the International Stroke Society
Jorge A ZavalaGeoffrey A Donnan

Abstract

Severe atheroma of the aortic arch has now been established as an important risk factor and mechanism for stroke and peripheral embolism. The odds ratio for stroke or peripheral embolism in patients with severe arch atheroma is greater than four, and for mobile atheroma it is greater than 12. The prevalence of severe arch atheroma among patients presenting with acute ischaemic stroke, at over 20%, is in the same order as that of atrial fibrillation and carotid atherosclerosis. In patients with ischaemic stroke for which no cause has been identified, it is reasonable to determine as to whether they have severe arch atheroma by performing a transoesophageal echocardiogram. Recurrent stroke is common in patients with aortic arch atheroma that are thicker than 4 mm or with mobile components, particularly in the elderly, cigarette smokers, and those with hypertension or diabetes. Patients found to have severe atheroma are at high risk of recurrent events (14.2% per year) and may, therefore, need an aggressive secondary prevention strategy. Currently, there is uncertainty as to what this should be, but either combination antiplatelet therapy (aspirin plus clopidogrel) or anticoagulation with warfarin (target INR 2.0-3.0) are commonly...Continue Reading

References

Feb 8, 1992·Lancet·R Bonita
Jul 1, 1992·Stroke; a Journal of Cerebral Circulation·P AmarencoM G Bousser
Aug 13, 1992·The New England Journal of Medicine·D HausmannW G Daniel
Aug 1, 1992·Stroke; a Journal of Cerebral Circulation·K ToyodaT Yamaguchi
Jan 23, 1992·The New England Journal of Medicine·P AmarencoJ J Hauw
Aug 15, 1991·The New England Journal of Medicine·UNKNOWN North American Symptomatic Carotid Endarterectomy Trial CollaboratorsM Eliasziw
Sep 15, 1991·Annals of Internal Medicine·P A TunickI Kronzon
Jan 11, 1991·Journal of the American College of Cardiology·D G KaralisG S Mintz
Dec 1, 1994·The New England Journal of Medicine·P AmarencoM G Bousser
Apr 1, 1994·Journal of the American College of Cardiology·P A TunickI Kronzon
May 15, 1993·The American Journal of Cardiology·P NihoyannopoulosC M Oakley
Jan 1, 1996·Journal of the American College of Cardiology·D H MontgomeryW R Taylor
Mar 1, 1996·Journal of the American College of Cardiology·M KhatibzadehA Sheikhzadeh
May 9, 1996·The New England Journal of Medicine·UNKNOWN French Study of Aortic Plaques in Stroke GroupM-G Bousser
Jan 1, 1997·Stroke; a Journal of Cerebral Circulation·R MituschA Sheikhzadeh
Jan 13, 1998·Journal of the American College of Cardiology·F A DresslerA J Labovitz
Feb 19, 1998·The American Journal of Cardiology·C TribouilloyJ P Lesbre
Jan 1, 1997·Journal of Tongji Medical University = Tong Ji Yi Ke Da Xue Xue Bao·Y GuoC M Kessler
Feb 5, 1999·Seminars in Neurology·M S Elkind, R L Sacco
Feb 12, 1999·Cerebrovascular Diseases·G A Lammie, J M Wardlaw
Apr 8, 1999·Journal of the American College of Cardiology·E FerrariM Baudouy
Dec 3, 1999·Stroke; a Journal of Cerebral Circulation·G W PettyD O Wiebers
Feb 19, 2000·Neurology·A Geraci, J Weinberger
Dec 15, 2000·Chest·C M TribouilloyJ P Lesbre
Dec 12, 2001·Stroke; a Journal of Cerebral Circulation·G W Albers, P Amarenco
Feb 9, 2002·The Annals of Thoracic Surgery·Gilead LancasterJohn A Elefteriades
Apr 6, 2002·Stroke; a Journal of Cerebral Circulation·Souvik SenBarry Cohen

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Citations

Mar 30, 2013·Current Treatment Options in Cardiovascular Medicine·Thalia S FieldOscar R Benavente
Oct 27, 2011·Journal of Atherosclerosis and Thrombosis·Gregory TelmanYoram Agmon
Oct 13, 2011·International Journal of Stroke : Official Journal of the International Stroke Society·Austin G MiltonSimon A Koblar
May 11, 2016·The Journal of Thoracic and Cardiovascular Surgery·Salome WeissThomas R Wyss
Nov 29, 2007·Cerebrovascular Diseases·Carlos A MolinaJosé Alvarez-Sabín
Feb 2, 2021·Frontiers in Neurology·Elena Viedma-GuiardElena Meseguer
Jun 19, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Renate B SchnabelKarl Georg Haeusler

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Methods Mentioned

BETA
surgical resection

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