Effect of treatment on the incidence of stroke and other emboli in 519 patients with severe thoracic aortic plaque

Tunick, Paul A.; Nayar, Ambika C.; Goodkin, Gregory M.

doi:10.1016/s1062-1458(03)00057-6

Cited by 67 publications

(94 citation statements)

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“…2) The major sources of embolism include a left atrium or left atrial appendage thrombus in atrial fibrillation, a left ventricular thrombus in patients with myocardial infarction, and a thrombus originating from complex plaque in the aorta. 3,4,5) Left ventricular thrombosis is associated with an increased risk of embolism. 6,7) Systemic embolism occurred in 4%-63% of patients with a ventricular thrombus documented by echocardiography.…”

Section: Discussionmentioning

confidence: 99%

Rupture and Bleeding Secondary to Renal Infarction in a Patient with an Abdominal Aortic Aneurysm

Hiraoka

Mukai

Obata

et al. 2014

ATCS

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A 57-year-old man had been followed up for severe left ventricular dysfunction after acute myocardial infarction with a left ventricular thrombus. He had been treated with anticoagulant and antiplatelet therapy and was admitted to our hospital because of abdominal pain and shock. He had no prior episode of trauma. The electrocardiogram (ECG) showed no changes compared with the previous ECG. Enhanced abdominal computed tomography (CT) showed a retroperitoneal hematoma around an abdominal aortic aneurysm (AAA) and the right kidney. We suspected rupture of AAA or the right kidney, and we performed AAA replacement with a Y-shaped graft and nephrectomy of the right kidney. Pathological examination revealed hemorrhagic infarction of the lower part of the right kidney, with hemorrhage and rupture at the center of the infarct. In our case, enhanced CT showed extravasation from the lower part of the right kidney. In addition, postoperative echocardiography showed that the left ventricular thrombus had disappeared. We report a case of rupture and bleeding secondary to renal infarction in a patient with an AAA.

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Section: Discussionmentioning

confidence: 99%

Rupture and Bleeding Secondary to Renal Infarction in a Patient with an Abdominal Aortic Aneurysm

Hiraoka

Mukai

Obata

et al. 2014

ATCS

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“…It is important to recognize that carotid artery stenosis represents only a part of the atherosclerosis in the body. 1,7,11,15) Therefore, in patients with carotid artery stenosis, the approach routes and the arterial condition of the entire body should be evaluated before treatment. If we know that the patient has type III aortic arch or bovine arch, the trans-brachial approach may be a better route to choose.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Computed Tomography Angiography for the Detection of High-Risk Aortas for Carotid Artery Stenting

Yamamoto

Kuwayama

Hayashi

et al. 2011

Neurol. Med. Chir.(Tokyo)

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This study evaluated the usefulness of computed tomography (CT) angiography for the detection of high-risk aortas for carotid artery stenting (CAS). We investigated changes in the treatment method and modifications of endovascular techniques according to the information from CT angiography. CT angiography using three-dimensional and multi-planar reconstruction was performed in 43 consecutive patients with carotid artery stenoses intended to undergo CAS. Two neurosurgeons evaluated the images and estimated the risk and difficulties of CAS. CT angiography clearly depicted the entire aorta, the supra-aortic vessels, and the ilio-femoral arteries in all patients. Abnormal vascular findings were found in 17 patients. High-risk aortic lesions for CAS were detected in 5 patients, including thick aortic plaques with thrombi in 2. We changed the treatment strategy from CAS to carotid endarterectomy (CEA) in these 2 patients. CT angiograms proved very useful in evaluating the approach routes of CAS in 12 patients. One patient had dissecting aneurysm of the thoracic aorta and another had aberrant right vertebral artery. In these two, the treatment strategy was changed from CAS to CEA. The treatment method was changed in 4 patients in total. CT angiography is useful for the detection of high-risk aortas for CAS and for the evaluation of safe approaches to the carotid artery.

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“…Identification of an aortic atheroma may prompt therapy with aspirin, statins and/ or anticoagulation to prevent recurrent strokes (125,126). Using statins in such patients decreases the likelihood of a subsequent stroke (127). Patients with an ejection fraction of < 30% and a predicted 5 year survival tend to do better if anticoagulated (128).…”

Section: Secondary Preventionmentioning

confidence: 99%

Acute Ischemic Stroke Management Review for the Hospitalist

Haldal¹,

Beary²,

Nattanmai³

et al. 2018

Am J Hosp Med

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Effect of treatment on the incidence of stroke and other emboli in 519 patients with severe thoracic aortic plaque

Cited by 67 publications

References 0 publications

Rupture and Bleeding Secondary to Renal Infarction in a Patient with an Abdominal Aortic Aneurysm

Rupture and Bleeding Secondary to Renal Infarction in a Patient with an Abdominal Aortic Aneurysm

Usefulness of Computed Tomography Angiography for the Detection of High-Risk Aortas for Carotid Artery Stenting

Acute Ischemic Stroke Management Review for the Hospitalist

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