Ulcerated atherosclerotic plaques in the thoracic aorta are associated with cryptogenic stroke: A multiplane transesophageal echocardiographic study

David A. Stone, Mary W. Hawke, Marian LaMonte, Steven J. Kittner, Joseph Acosta, Mary Corretti, Cindy Sample, Thomas R. Price, Gary D. Plotnick

Research output: Contribution to journalArticlepeer-review

Abstract

Atherosclerotic plaque ulcers ≥2 mm in depth and width in the thoracic aorta have been implicated by autopsy study as a cause of unexplained or cryptogenic ischemic strokes. Transesophageal echocardiography (TEE) allows visualization of complex atherosclerotic lesions of the thoracic aorta. We compared the prevalence of thoracic aorta ulcerated plaques (ulcers ≥2 mm in both depth and width) in three age-matched groups undergoing multiplane TEE: group 1, 23 patients with cryptogenic ischemic stroke; group 2, 26 patients with known-cause strokes; and group 3, 57 control patients without strokes. TEEs were interpreted in a blinded fashion. Ulcerated plaques were found in 9 (39%) group 1 patients but in only 2 (8%) group 2 patients and in only 4 (7%) group 3 patients (p < 0.001). There was an association between advancing age and the presence of ulcerated plaques (p < 0.02). We conclude that ulcerated atherosclerotic plaques in the thoracic aorta are associated with cryptogenic ischemic stroke and should be considered a potential source of cerebral emboli.

Original languageEnglish (US)
Pages (from-to)105-108
Number of pages4
JournalAmerican heart journal
Volume130
Issue number1
DOIs
StatePublished - Jul 1995

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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