Atheromatosis of the Aortic Arch as an Occult Source of Multiple Systemic Emboli

Abstract

Brief Reports1 March 1991Atheromatosis of the Aortic Arch as an Occult Source of Multiple Systemic EmboliPaul A. Tunick, MD, Alfred T. Culliford, MD, Patrick J. Lamparello, MD, Itzhak Kronzon, MDPaul A. Tunick, MD, Alfred T. Culliford, MD, Patrick J. Lamparello, MD, Itzhak Kronzon, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-5-391 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAtheroemboli may occur after catheter or surgical manipulation of the abdominal aorta, causing arterial obstruction (1). They may also occur during cardiac catheterization (2). Our laboratory previously reported three patients with embolization in whom a new finding, protruding masses with mobile components in the aortic arch and descending aorta, was seen during transesophageal echocardiography (3). We have subsequently found protruding plaques in another 29 patients. One of these patients had surgical exploration of the aortic arch because of four emboli during a 2-month period. The existence and location of the protruding plaque in this patient would not have been known...References1. Braunwald E, ed. Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia: W.B. Saunders; 1988:1571. 1835. Google Scholar2. RamirezO'NeillLambertBloomer GWRH. Cholesterol embolization: a complication of angiography. Arch Intern Med. 1978; 138:1430-2. CrossrefMedlineGoogle Scholar3. TunickKronzon PI. Protruding atherosclerotic plaque in the aortic arch of patients with systemic embolization: a new finding seen by transesophageal echocardiography. Am Heart J. 1990;120:658-60. CrossrefMedlineGoogle Scholar4. WolfKannelSorlieMcNamara PWPP. Asymptomatic carotid bruit and the risk of stroke. The Framingham Study. JAMA. 1981;245:1442-5. CrossrefMedlineGoogle Scholar5. GreenlandKnopmanMikellAsingerAndersonGood PDFRDD. Echocardiography in diagnostic assessment of stroke. Ann Intern Med. 1981;95:51-3. LinkGoogle Scholar6. PopSutherlandKoudstaalSitde JongRodandt GGPTGJ. Transesophageal echocardiography in the detection of intracardiac embolic sources in patients with transient ischemic attacks. Stroke. 1990;21:560-5. CrossrefMedlineGoogle Scholar7. Moldveen-GeronimusMerriam MJ. Cholesterol embolization. From pathologic curiosity to clinical entity. Circulation. 1967;35:946-53. CrossrefMedlineGoogle Scholar8. CullifordColvinRohrerBaumannSpencer ASKFF. The atherosclerotic ascending aorta and transverse arch: a new technique to prevent cerebral injury during bypass. Experience with 13 patients. Ann Thorac Surg. 1986;41:27-35. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the New York University Medical Center, New York, New York. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPreservation of Renal FunctionAtherosclerotic Disease of the Proximal AortaEACVI recommendations on cardiovascular imaging for the detection of embolic sources: endorsed by the Canadian Society of EchocardiographyAortogenic cerebral embolism treated by ascending aorta replacement in an 80-year-old maleThoracic Aortic Aneurysms, Fistula, and ThrombusAtherosclerotic Disease of the Proximal AortaAortic AtherosclerosisAortic Atherosclerosis as an Embolic SourceEffects of Medical Treatment on the Prognosis and Risk of Embolic Events in Patients with Severe Aortic PlaqueThrombus in the Non-aneurysmal, Non-atherosclerotic Descending Thoracic Aorta – An Unusual Source of Arterial EmbolismAtherosclerotic Disease of the Proximal Aorta2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic DiseaseAortic arch plaque in strokeBrain EmbolismAortic Atherosclerosis, Hypercoagulability, and StrokeAssociation of Aortic Atherosclerosis and Renal DysfunctionCerebrovascular Disease in the Elderly PatientTransesophageal Echocardiographic Assessment of a Floating Thrombus Located in the Ascending AortaSignificance of aortic atheroma in elderly patients with ischemic strokeAortic Atherosclerotic Disease and StrokeCardiac Disease and Stroke: Will History Repeat Itself?Correlation between coronary artery disease and aortic arch plaque thickness measured by non-invasive B-mode ultrasonographyAtheroembolismRole of transoesophageal echocardiography in determining the source of peripheral arterial embolismCan Transthoracic Echocardiography with Subcostal View Predict Abdominal Aortic Atherosclerosis?Diagnosis and Prevention of Atherosclerotic Cerebral InfarctionDistal Peripheral MicroembolismThrombus flottant de la crosse de l'aorte : une cause rare d'embolies artérielles périphériquesCryptogenic Emboli and Other Elusive Causes of StrokeAtherosclerotic Disease of the Proximal AortaThoracic aorta imaging with multisclice CTCisplatin Induced Localized Aortic ThrombusNoninvasive imaging of atherosclerotic plaque in the arch of the aorta with transcutaneous B-mode ultrasonographyTransesophageal echocardiography aortic plaque imagingLesiones neurológicas durante la circulación extracorpórea: fisiopatología, monitorización y protección neurológicaCerebral Protection Systems for Distal Emboli During Carotid Artery InterventionsMitral annulus calcification — a window to diffuse atherosclerosis of the vascular systemAortic Arch Atherosclerotic DiseaseLe thrombus de la crosse de l'aorte : une pathologie rare en réanimationDiagnostic Imaging of Thoracic Aortic AtherosclerosisAtheromas of the thoracic aorta: clinical and therapeutic updateMobile thrombi in the abdominal aorta in cases of lower extremity embolic arterial occlusion: Value of extended transthoracic echocardiographyAortic atheroma morphology and the risk of ischemic stroke in a multiethnic populationProtruding aortic arch atheromas: Risk of stroke during heart surgery with and without aortic arch endarterectomyBrain EmbolismAtherosclerosis of the thoracic aorta and aortic debris as a marker of poor prognosis: benefit of oral anticoagulantsEffects of pravastatin on thoracic aortic atherosclerosis in patients with heterozygous familial hypercholesterolemiaAcute limb ischaemia due to paradoxical embolism from a long-term central venous catheterEmboli in transit: The missing linkA New Noninvasive Technique for Imaging Atherosclerotic Plaque in the Aortic Arch of Stroke Patients by Transcutaneous Real-Time B-Mode UltrasonographyMobile Aortic Atheroma and Systemic Emboli: Efficacy of Anticoagulation and Influence of Plaque Morphology on Recurrent StrokeMobile atheroma of the aortic arch is an underestimated source of embolizationPathologic Correlates of Aortic Plaques, Thrombi and Mobile "Aortic Debris" Imaged In Vivo With Transesophageal EchocardiographyMobile Thromboses of the Aortic Arch Without Aortic DebrisCerebrovascular Disease and StrokeAortic Arch Atherosclerotic DiseaseChanging patterns of atheroembolismMassive aortic thrombus detected by transesophageal echocardiography as a cause of peripheral emboli in young patientsTRANSESOPHAGEAL ECHOCARDIOGRAPHYTHE AORTAAbsence of atherosclerotic lesions in the thoracic aorta indicates absence of significant coronary artery diseaseTRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF EMBOLIC SOURCESAortic atherosclerotic plaques as a source of systemic embolismTransesophageal Echocardiography in Thoracic Aortic AtherosclerosisAortic atheromatosis and risks of cerebral embolizationExcision of focal aortic arch atheroma using deep hypothermic circulatory arrestConcluding CommentsConcluding CommentsThe Central Nervous System: Responses to Cardiopulmonary BypassProtruding atheromas of the aortic arch in symptomatic patients with carotid artery diseaseUtility of transesophageal echocardiography in the diagnosis of disease of the thoracic aortaMassive Acute Thrombosis of the Descending Thoracic Aorta in Heparin-associated Thrombocytopenia and ThrombosisTransesophageal echocardiography and carotid ultrasound in patients with cerebral ischemia: Prevalence of findings and recurrent stroke riskHigh risk for vascular events in patients with protruding aortic atheromas: A prospective studyRecurrent systemic embolization caused by aortic thrombiSuperiority of transesophageal echocardiography in detecting aortic arch atheromatous disease: Identification of patients at increased risk of stroke during cardiac surgerySouthwestern Internal Medicine Conference: Clinical Applications of Transesophageal EchocardiographyRationelle Diagnostik bei akutem Verschluß von ExtremitätenarterienUsefulness of transesophageal echocardiography in unexplained cerebral ischemiaAorta: Comprehensive Evaluation by Echocardiography and Transesophageal EchocardiographyThrombus of the Ascending Aorta as a Source of Cerebral EmbolismTransesophageal echocardiography in patients with heparin-induced thrombocytopenia and thrombosisRole of Transesophageal Echocardiography in Dissection of the Aorta and Evaluation of Degenerative Aortic DiseaseTransesophageal echocardiography as a tool in the evaluation of patients with embolic disordersProtruding Atheromas in the Thoracic Aorta:.Disappearance of a large intraaortic mass in a patient with prior systemic embolizationBlue Digit Syndrome: Transesophageal Echocardiographic Identification of Thoracic Aortic Plaque-Related Thrombi and Successful Outcome With WarfarinDigital Embolization From Plaque-Related Thrombus in the Thoracic Aorta: Identification With Transesophageal Echocardiography and Resolution With Warfarin TherapyARTERIAL EMBOLISMAortic Dissection Complicating Cardiac Surgery: Diagnosis by Intraoperative Biplane Transesophageal EchocardiographyCholesterol Embolism in Intensive Care PatientsDiagnosis of patent foramen ovale by transesophageal and transthoracic echocardiographyTransesophageal Echocardiography in the Evaluation of StrokeFrances A. DeRook, MD, Keith A. Comess, MD, Gregory W. Albers, MD, Richard L. Popp, MDThe Improved Yield of Transesophageal Echocardiography Over Transthoracic Echocardiography in Patients with Neurological Events is Largely Due to the Detection of Aortic Protruding AtheromasSuccessful Thrombolysis of an Aortic-Arch Thrombus in a Patient after Mesenteric EmbolismThe ligamentum arteriosum: An unreproted origin of peripheral emboli diagnosed by transesophageal echocardiographyMultiple emboli from a large aortic arch thrombus in a patient with thrombotic diathesisProtruding aortic atheromas predict stroke in elderly patients undergoing cardiopulmonary bypass: Experience with intraoperative transesophageal echocardiographyHistologically Confirmed Cholesterol Atheroemboli with Identification of the Source by Transesophageal EchocardiographyTransesophageal echocardiographic detection of aortic atheromatosis may provide clues to occult renal dysfunction in the elderlyTransoesophageal echocardiographyGuidelines for Physician Training in Transesophag. eal Echocardiography: Recommendations of the American Society of Echocardiography Committee for Physician Training in EchocardiographyTransesophageal Echocardiography for Aortic AneurysmSteven L. Hersch, MDTransesophageal echocardiography: Procedures and clinical applicationProtruding Atheromas in the Thoracic Aorta and Systemic EmbolizationPaul A. Tunick, MD, John L. Perez, BA, Itzhak Kronzon, MD 1 March 1991Volume 114, Issue 5Page: 391-392KeywordsAortaCatheterizationCathetersEchocardiographyResearch laboratories Issue Published: 1 March 1991 PDF downloadLoading ...