Mobile Aortic Atheroma and Systemic Emboli: Efficacy of Anticoagulation and Influence of Plaque Morphology on Recurrent Stroke

Dressler, Frederick A.; Craig, William R.; Castelló, Ramón; Labovitz, Arthur J.

doi:10.1016/s0735-1097(97)00449-x

Cited by 210 publications

(96 citation statements)

References 24 publications

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“…19,20 However, there is no evidence based treatment for this situation so far. With disappearance of aortic thrombi in TEE control 4 weeks later, medication was changed to platelet inhibitors plus statins for plaque stabilization in our patients.…”

Section: Clinical Implications Of Cardiac High-risk Sources In Teementioning

confidence: 99%

Therapeutic Strategies After Examination by Transesophageal Echocardiography in 503 Patients With Ischemic Stroke

Harloff

Handke

Reinhard

et al. 2006

Stroke

127

109

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Section: Clinical Implications Of Cardiac High-risk Sources In Teementioning

confidence: 99%

Therapeutic Strategies After Examination by Transesophageal Echocardiography in 503 Patients With Ischemic Stroke

Harloff

Handke

Reinhard

et al. 2006

Stroke

127

109

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“…Earlier studies reported a potential benefit of anticoagulation. 30,31 On the other hand, Tunick et al 32 found no significant benefit of anticoagulant or antiplatelet drugs for patients with ACL. A large prospective study is needed to determine which of these are better for patients with ACL.…”

Section: Discussionmentioning

confidence: 99%

Predictors of aortic complicated lesions in stroke patients

et al. 2009

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Aortic complicated lesions (ACLs) should be associated with cerebral infarction. Our aim was to develop a simple clinical scale (ACL scale) to predict the presence of ACL. Consecutive stroke patients undergoing transesophageal echocardiogram (TEE) examination were prospectively enrolled. We defined ACL as the presence of 44 mm wall thickness, ulceration or mobile plaque in aortic arch. We also examined carotid intima-media thickness (IMT), ankle-brachial index (ABI) and brachial-ankle pulse-wave velocity (baPWV). We compared the clinical characteristics of patients with ACL (ACL group) and without ACL (non-ACL group), and devised a new ACL scale to predict the presence of ACL. In all, 165 patients (male 108, age 66.9 years) were enrolled and of these, 38% had ACL. The patients of the ACL group were older than those of the non-ACL group (73.0±10.2 vs. 63.1±13.6 years, P¼0.001). Peripheral artery disease (PAD) was more frequent in the ACL group (18 vs. 4%, P¼0.004). IMT was thicker in ACL group than in the non-ACL group (1.29 ± 0.74 vs. 1.11 ± 0.79 mm, P¼0.002), and baPWV was higher in the ACL group (2164.2 ± 643.2 vs. 1833.7 ± 492.9 cm s À1 , P¼0.001). We used three variables for determining the ACL scale score; (1) age 470, (2) presence of PAD and (3) smoking. The frequencies of ACL associated with ACL scale scores were as follows: 6% of patients with ACL scale score 0, 40% with score 1, 58% with score 2 and 100% with score 3. The ACL scale can predict the presence of aortic complicated lesions.

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“…Warfarin was reported efficacious in preventing stroke in patients with mobile aortic atheroma. 5) On the other hand, anticoagulation was reported in association with new or worsening atheroemboli, possibly because of bleeding into the plaques. 7) Therefore, warfarin was not used in the present case.…”

Section: Discussionmentioning

confidence: 99%

Repeated Brain Infarction Caused by Atherosclerosis of the Bovine Aortic Arch Successfully Treated With Arch Replacement

Yamashita

Hiramatsu

Washiyama

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 62-year-old man presented with repeated embolic infarction over the last 3 years. Computed tomography angiography of the aortic arch revealed that the patient had a common trunk for the innominate and left carotid arteries, the so-called bovine aortic arch, with stenosis extending to both the left common carotid artery and innominate artery. Since antiplatelet therapy was not adequate for prevention of recurrent infarction, total replacement of the aortic arch was performed. Since then, no further ischemic events have manifested. Endovascular procedures are not safe enough for atherosclerotic lesions in the aortic arch, especially in a patient with bovine aortic arch, so surgical aortic arch replacement should be considered.

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Mobile Aortic Atheroma and Systemic Emboli: Efficacy of Anticoagulation and Influence of Plaque Morphology on Recurrent Stroke

Cited by 210 publications

References 24 publications

Therapeutic Strategies After Examination by Transesophageal Echocardiography in 503 Patients With Ischemic Stroke

Therapeutic Strategies After Examination by Transesophageal Echocardiography in 503 Patients With Ischemic Stroke

Predictors of aortic complicated lesions in stroke patients

Repeated Brain Infarction Caused by Atherosclerosis of the Bovine Aortic Arch Successfully Treated With Arch Replacement

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