Aortic arch atheroma and stroke

Abstract

The development of transoesophageal echocardiography as a relatively non-invasive means of imaging the aortic arch has led to the discovery of this region as a potential cause of stroke. There is in vivo and autopsy evidence that aortic arch atheroma is an independent risk factor for ischaemic stroke and that the risk is of the same order of magnitude as the well established risk factors such as hypertension, carotid stenosis and atrial fibrillation. The most common mechanism of stroke development is probably by virtue of embolic debris lodging within the cerebral circulation. Transoesophageal echocardiography as a means of detecting aortic arch atheroma is indicated in patients with embolic..