Recognition and embolic potential of intraaortic atherosclerotic debris.

Published on Jan 1, 1991in Journal of the American College of Cardiology24.093
路 DOI :10.1016/0735-1097(91)90706-F
Dean G. Karalis10
Estimated H-index: 10
(Hahnemann University Hospital),
Mark F. Victor10
Estimated H-index: 10
(Hahnemann University Hospital)
+ 2 AuthorsGary S. Mintz41
Estimated H-index: 41
(Hahnemann University Hospital)
Sources
Abstract
Abstract Atherosclerotic disease of the thoracic aorta is common in the elderly and patients with clinical coronary artery disease. Although emholization can occur from atherosclerotic debris within the thoracic aorta, it is not commonly considered in the differential diagnosis of the source of a systemic embolism. In the current study, the prevalence, clinical significance and embolic potential of intraaortic atherosclerotic debris as detected by transesophageal echocardiography was determined. Intraaortic atherosclerotic debris was identified in 38 17%) of 556 patients undergoing transesophageal echocardiography. An embolic event occurred among 11 (31%) of the 36 study patients with inlraaortic atherosclerotic debris. The incidence of an embolic event was higher when the debris was pedunculated and highly mobile (8 [73%] of 11 patients) than when it was layered and immobile (3 [12%] of 25 patients) (p In conclusion, in a patient with an embolic event, the thoracic aorta should be considered as a potential source. Transesophageal echocardiography can reliably detect intraaortic atherosclerotic debris, and when it is identified, an invasive aortic procedure should be avoided if possible.
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Embolization of atherosclerotic material from the ascending aorta resulting from placement of cannulas or vascular clamps is a major cause of stroke during cardiac surgical procedures. In an effort to identify atherosclerotic disease of the ascending aorta which might predispose to embolization, intraoperative B-mode ultrasonography was performed in 50 patients. The aorta was imaged from the aortic annulus to the origin of the innominate artery in transverse and longitudinal views. The results w...
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Cardioaortic embolism to the brain accounts for approximately 15-30% of ischaemic strokes and is often referred to as 'cardioembolic stroke'. One-quarter of patients have more than one cardiac source of embolism and 15% have significant cerebrovascular atherosclerosis. After a careful work-up, up to 30% of ischaemic strokes remain 'cryptogenic', recently redefined as 'embolic strokes of undetermined source'. The diagnosis of cardioembolic stroke remains difficult because a potential cardiac sour...
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Background Ascending aortic thrombus (AAT) in a nonaneurysmal aorta is an extremely rare event and has potentially catastrophic complications, with a life-threatening risk of myocardial infarction and cerebral embolization. This systematic review aims to elucidate the clinical manifestations and to compare the outcomes of anticoagulation therapy versus open aortic surgery for AAT. Methods The MEDLINE/PubMed databases were extensively searched between 1995 and 2019. All relevant publications on A...
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