Protruding atheromas of the aortic arch in symptomatic patients with carotid artery disease
Protruding aortic arch atheromas are associated with otherwise unexplained strokes and transient ischemic attacks. Therefore aortic atheromas also may be important in patients with carotid artery disease. Forty-five patients with ≥50% carotid stenosis and stroke or transient ischemic attack within 6...
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| Veröffentlicht in: | The American heart journal 1995, Vol.129 (1), p.40-44 |
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| creator | Demopoulos, Laura A. Tunick, Paul A. Bernstein, Neil E. Perez, John L. Kronzon, Itzhak |
| description | Protruding aortic arch atheromas are associated with otherwise unexplained strokes and transient ischemic attacks. Therefore aortic atheromas also may be important in patients with carotid artery disease. Forty-five patients with ≥50% carotid stenosis and stroke or transient ischemic attack within 6 weeks underwent transesophageal echocardiographic examination (TEE). They were matched for age, sex, and hypertension with 45 control subjects who had also had a recent cerebral event but in whom significant carotid stenosis was absent. Protruding aortic arch atheromas were present in 17 (38%) of 45 patients with carotid disease and only 7 (16%) of 45 of control subjects (
p = 0.02). Mobile atheromas (with the greatest embolic potential) were present almost exclusively in case patients, 6 (13%) of 45, versus 1 (2%) of 45 control subjects (
p = 0.05). Case patients with mobile atheromas had the most severe carotid stenosis (≥80%). Cerebral symptoms were discordant with the side of the carotid stenosis in 10 case patients, and 4 had atheromas. In conclusion, protruding atheromas of the aortic arch are present in significant numbers of symptomatic patients with carotid artery disease. These atheromas may represent an additional cause of symptoms in patients with carotid stenosis. TEE to look for protruding aortic atheromas may be considered in patients with neurologic events despite the presence of significant carotid stenosis, especially if the symptoms are discordant with the side of carotid stenosis. |
| doi_str_mv | 10.1016/0002-8703(95)90040-3 |
| format | Article |
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p = 0.02). Mobile atheromas (with the greatest embolic potential) were present almost exclusively in case patients, 6 (13%) of 45, versus 1 (2%) of 45 control subjects (
p = 0.05). Case patients with mobile atheromas had the most severe carotid stenosis (≥80%). Cerebral symptoms were discordant with the side of the carotid stenosis in 10 case patients, and 4 had atheromas. In conclusion, protruding atheromas of the aortic arch are present in significant numbers of symptomatic patients with carotid artery disease. These atheromas may represent an additional cause of symptoms in patients with carotid stenosis. TEE to look for protruding aortic atheromas may be considered in patients with neurologic events despite the presence of significant carotid stenosis, especially if the symptoms are discordant with the side of carotid stenosis.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/0002-8703(95)90040-3</identifier><identifier>PMID: 7817922</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Aorta, Thoracic - diagnostic imaging ; Aortic Arch Syndromes - complications ; Aortic Arch Syndromes - diagnostic imaging ; Aortic Arch Syndromes - epidemiology ; Arteriosclerosis - complications ; Arteriosclerosis - diagnostic imaging ; Arteriosclerosis - epidemiology ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Carotid Artery, Internal - diagnostic imaging ; Carotid Stenosis - complications ; Carotid Stenosis - diagnostic imaging ; Carotid Stenosis - epidemiology ; Case-Control Studies ; Cerebrovascular Disorders - diagnostic imaging ; Cerebrovascular Disorders - etiology ; Diseases of the aorta ; Echocardiography, Transesophageal - instrumentation ; Echocardiography, Transesophageal - methods ; Echocardiography, Transesophageal - statistics & numerical data ; Female ; Humans ; Hypertension - diagnostic imaging ; Incidence ; Ischemic Attack, Transient - diagnostic imaging ; Ischemic Attack, Transient - etiology ; Male ; Medical sciences ; Observer Variation ; Risk Factors</subject><ispartof>The American heart journal, 1995, Vol.129 (1), p.40-44</ispartof><rights>1995</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-c3298c1ed3edd44f746fe82aab1524d1d724767414e6f0d460bf34158e5101593</citedby><cites>FETCH-LOGICAL-c386t-c3298c1ed3edd44f746fe82aab1524d1d724767414e6f0d460bf34158e5101593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0002-8703(95)90040-3$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3398051$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7817922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Demopoulos, Laura A.</creatorcontrib><creatorcontrib>Tunick, Paul A.</creatorcontrib><creatorcontrib>Bernstein, Neil E.</creatorcontrib><creatorcontrib>Perez, John L.</creatorcontrib><creatorcontrib>Kronzon, Itzhak</creatorcontrib><title>Protruding atheromas of the aortic arch in symptomatic patients with carotid artery disease</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Protruding aortic arch atheromas are associated with otherwise unexplained strokes and transient ischemic attacks. Therefore aortic atheromas also may be important in patients with carotid artery disease. Forty-five patients with ≥50% carotid stenosis and stroke or transient ischemic attack within 6 weeks underwent transesophageal echocardiographic examination (TEE). They were matched for age, sex, and hypertension with 45 control subjects who had also had a recent cerebral event but in whom significant carotid stenosis was absent. Protruding aortic arch atheromas were present in 17 (38%) of 45 patients with carotid disease and only 7 (16%) of 45 of control subjects (
p = 0.02). Mobile atheromas (with the greatest embolic potential) were present almost exclusively in case patients, 6 (13%) of 45, versus 1 (2%) of 45 control subjects (
p = 0.05). Case patients with mobile atheromas had the most severe carotid stenosis (≥80%). Cerebral symptoms were discordant with the side of the carotid stenosis in 10 case patients, and 4 had atheromas. In conclusion, protruding atheromas of the aortic arch are present in significant numbers of symptomatic patients with carotid artery disease. These atheromas may represent an additional cause of symptoms in patients with carotid stenosis. TEE to look for protruding aortic atheromas may be considered in patients with neurologic events despite the presence of significant carotid stenosis, especially if the symptoms are discordant with the side of carotid stenosis.</description><subject>Aged</subject><subject>Aorta, Thoracic - diagnostic imaging</subject><subject>Aortic Arch Syndromes - complications</subject><subject>Aortic Arch Syndromes - diagnostic imaging</subject><subject>Aortic Arch Syndromes - epidemiology</subject><subject>Arteriosclerosis - complications</subject><subject>Arteriosclerosis - diagnostic imaging</subject><subject>Arteriosclerosis - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Carotid Artery, Internal - diagnostic imaging</subject><subject>Carotid Stenosis - complications</subject><subject>Carotid Stenosis - diagnostic imaging</subject><subject>Carotid Stenosis - epidemiology</subject><subject>Case-Control Studies</subject><subject>Cerebrovascular Disorders - diagnostic imaging</subject><subject>Cerebrovascular Disorders - etiology</subject><subject>Diseases of the aorta</subject><subject>Echocardiography, Transesophageal - instrumentation</subject><subject>Echocardiography, Transesophageal - methods</subject><subject>Echocardiography, Transesophageal - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - diagnostic imaging</subject><subject>Incidence</subject><subject>Ischemic Attack, Transient - diagnostic imaging</subject><subject>Ischemic Attack, Transient - etiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Observer Variation</subject><subject>Risk Factors</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtPGzEURi1EFQLlH4DkBUKwmNavsT0bJBTxkiK1i7JiYTn2HWKUmQm2A8q_r0OiLNlcP-65n-yD0Bklvyih8jchhFVaEX7V1NcNIYJU_ACNKWlUJZUQh2i8R47QcUpv5SiZliM0UpqqhrExevkbhxxXPvSv2OY5xKGzCQ8tLntsh5iDwza6OQ49TutumUt_c7csFfqc8GfIc-xsSQm-kBniGvuQwCb4iX60dpHgdLeeoOf7u3-Tx2r65-FpcjutHNcyl8oa7Sh4Dt4L0SohW9DM2hmtmfDUKyZU-RAVIFvihSSzlgtaa6iLh7rhJ-hym7uMw_sKUjZdSA4WC9vDsEpGKcqk_gLFFnRxSClCa5YxdDauDSVm49RshJmNMNPU5sup4WXsfJe_mnXg90M7iaV_sevb5OyijbZ3Ie0xzhtNalqwmy0GxcVHgGiSKw4d-BDBZeOH8P07_gPrZ5K1</recordid><startdate>1995</startdate><enddate>1995</enddate><creator>Demopoulos, Laura A.</creator><creator>Tunick, Paul A.</creator><creator>Bernstein, Neil E.</creator><creator>Perez, John L.</creator><creator>Kronzon, Itzhak</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1995</creationdate><title>Protruding atheromas of the aortic arch in symptomatic patients with carotid artery disease</title><author>Demopoulos, Laura A. ; Tunick, Paul A. ; Bernstein, Neil E. ; Perez, John L. ; Kronzon, Itzhak</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-c3298c1ed3edd44f746fe82aab1524d1d724767414e6f0d460bf34158e5101593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Aged</topic><topic>Aorta, Thoracic - diagnostic imaging</topic><topic>Aortic Arch Syndromes - complications</topic><topic>Aortic Arch Syndromes - diagnostic imaging</topic><topic>Aortic Arch Syndromes - epidemiology</topic><topic>Arteriosclerosis - complications</topic><topic>Arteriosclerosis - diagnostic imaging</topic><topic>Arteriosclerosis - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Carotid Artery, Internal - diagnostic imaging</topic><topic>Carotid Stenosis - complications</topic><topic>Carotid Stenosis - diagnostic imaging</topic><topic>Carotid Stenosis - epidemiology</topic><topic>Case-Control Studies</topic><topic>Cerebrovascular Disorders - diagnostic imaging</topic><topic>Cerebrovascular Disorders - etiology</topic><topic>Diseases of the aorta</topic><topic>Echocardiography, Transesophageal - instrumentation</topic><topic>Echocardiography, Transesophageal - methods</topic><topic>Echocardiography, Transesophageal - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - diagnostic imaging</topic><topic>Incidence</topic><topic>Ischemic Attack, Transient - diagnostic imaging</topic><topic>Ischemic Attack, Transient - etiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Observer Variation</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Demopoulos, Laura A.</creatorcontrib><creatorcontrib>Tunick, Paul A.</creatorcontrib><creatorcontrib>Bernstein, Neil E.</creatorcontrib><creatorcontrib>Perez, John L.</creatorcontrib><creatorcontrib>Kronzon, Itzhak</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Demopoulos, Laura A.</au><au>Tunick, Paul A.</au><au>Bernstein, Neil E.</au><au>Perez, John L.</au><au>Kronzon, Itzhak</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Protruding atheromas of the aortic arch in symptomatic patients with carotid artery disease</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>1995</date><risdate>1995</risdate><volume>129</volume><issue>1</issue><spage>40</spage><epage>44</epage><pages>40-44</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Protruding aortic arch atheromas are associated with otherwise unexplained strokes and transient ischemic attacks. Therefore aortic atheromas also may be important in patients with carotid artery disease. Forty-five patients with ≥50% carotid stenosis and stroke or transient ischemic attack within 6 weeks underwent transesophageal echocardiographic examination (TEE). They were matched for age, sex, and hypertension with 45 control subjects who had also had a recent cerebral event but in whom significant carotid stenosis was absent. Protruding aortic arch atheromas were present in 17 (38%) of 45 patients with carotid disease and only 7 (16%) of 45 of control subjects (
p = 0.02). Mobile atheromas (with the greatest embolic potential) were present almost exclusively in case patients, 6 (13%) of 45, versus 1 (2%) of 45 control subjects (
p = 0.05). Case patients with mobile atheromas had the most severe carotid stenosis (≥80%). Cerebral symptoms were discordant with the side of the carotid stenosis in 10 case patients, and 4 had atheromas. In conclusion, protruding atheromas of the aortic arch are present in significant numbers of symptomatic patients with carotid artery disease. These atheromas may represent an additional cause of symptoms in patients with carotid stenosis. TEE to look for protruding aortic atheromas may be considered in patients with neurologic events despite the presence of significant carotid stenosis, especially if the symptoms are discordant with the side of carotid stenosis.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>7817922</pmid><doi>10.1016/0002-8703(95)90040-3</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Aged Aorta, Thoracic - diagnostic imaging Aortic Arch Syndromes - complications Aortic Arch Syndromes - diagnostic imaging Aortic Arch Syndromes - epidemiology Arteriosclerosis - complications Arteriosclerosis - diagnostic imaging Arteriosclerosis - epidemiology Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Carotid Artery, Internal - diagnostic imaging Carotid Stenosis - complications Carotid Stenosis - diagnostic imaging Carotid Stenosis - epidemiology Case-Control Studies Cerebrovascular Disorders - diagnostic imaging Cerebrovascular Disorders - etiology Diseases of the aorta Echocardiography, Transesophageal - instrumentation Echocardiography, Transesophageal - methods Echocardiography, Transesophageal - statistics & numerical data Female Humans Hypertension - diagnostic imaging Incidence Ischemic Attack, Transient - diagnostic imaging Ischemic Attack, Transient - etiology Male Medical sciences Observer Variation Risk Factors |
| title | Protruding atheromas of the aortic arch in symptomatic patients with carotid artery disease |
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