Embolism from the Aorta: Atheroemboli and Thromboemboli

Current Treatment Options in Cardiovascular Medicine
P A Tunick, I Kronzon

Abstract

To date, there are no evidence-based data to support specific drug therapy for a patient with atheroembolism. It makes sense to use HMG CoA (3-hydroxy-3-methylglutaryl coenzyme A) reductase inhibitors (statins) in any patient with atherosclerosis, as these drugs have been shown to reduce the risk of myocardial infarction and stroke, and have a theoretical benefit on plaque stabilization. Surgical treatment should be considered for patients with abdominal aortic or popliteal artery aneurysms and downstream atheroembolism. There are case reports of atheroemboli in patients worsening after given warfarin or heparin. For this reason, some institutions are reluctant to prescribe these drugs for patients with atheroemboli or thromboemboli from aortic plaque. However, the incidence of this complication is quite low. Anticoagulation probably should be stopped if a patient develops atheroembolism. Similarly, the current state of knowledge does not allow for selecting specific pharmacologic intervention in patients with thromboemboli from aortic plaque. Statin therapy does make sense, as these drugs theoretically stabilize plaques and prevent plaque hemorrhage, thrombosis, and subsequent embolization. Unstable aortic plaques may develop ...Continue Reading

References

Sep 15, 1991·Annals of Internal Medicine·P A TunickI Kronzon
Dec 1, 1994·The New England Journal of Medicine·P AmarencoM G Bousser
May 1, 1994·Annals of Vascular Surgery·D S BaumannG A Sicard
Apr 1, 1994·Journal of the American College of Cardiology·P A TunickI Kronzon
May 9, 1996·The New England Journal of Medicine·UNKNOWN French Study of Aortic Plaques in Stroke GroupM-G Bousser
Sep 1, 1996·Current Opinion in Cardiology·R M Applebaum, I Kronzon
Apr 8, 1999·Journal of the American College of Cardiology·E FerrariM Baudouy
Mar 15, 2000·Journal of the American College of Cardiology·P A Tunick, I Kronzon

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Citations

May 19, 2006·Mayo Clinic Proceedings·Harold P Adams
Nov 13, 2008·Vascular and Endovascular Surgery·Gabriele PiffarettiPatrizio Castelli
Aug 11, 2010·Circulation·Itzhak Kronzon, Muhamed Saric
Oct 14, 2011·Current Opinion in Cardiology·Muhamed Saric, Itzhak Kronzon

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