Catheter-based aortography fails to identify aortic atherosclerotic lesions detected on transesophageal echocardiography.
OBJECTIVE
Transesophageal echocardiography is used to detect the aortic arch pathology during diagnostic workup of ischemic stroke events. Conventional angiography is increasingly used in diagnosing and treating atherosclerotic vascular lesions in patients with ischemic stroke. Although catheter-based aortography can be performed with cerebral angiography, there is limited information about the utility of aortography in identifying atherosclerotic abnormalities of the aortic arch.


METHODS
A retrospective chart review was performed to identify patients who underwent aortography as part of their angio-graphic study and transesophageal echocardiography. Both studies were reviewed independently in the absence of knowledge of the results of the other study. The findings of these aortograms were correlated with the findings of transesophageal echocardiography.


RESULTS
A total of 34 patients underwent both aortography and echocardiography. Of a total of 34 trans esophageal echocardiograms, 29 showed abnormal findings in the aorta (85%) and 5 appeared normal (15%). These aortic abnormalities included mild to moderate atherosclerosis in 18 cases (52%), moderate to severe atherosclerosis in 4 cases (12%), and severe atherosclerosis in 7 cases (21%). None of these abnormalities were detected by aortography. No disease was visualized in the origin of the supraaortic arteries.


CONCLUSIONS
Aortic arch atherosclerosis is common in patients with ischemic stroke; however, aortograms acquired during conventional angiography fail to identify abnormalities detected on transesophageal echocardiogram.
Khatri
Ismail A
IA
Zeenat Qureshi Stroke Research Center, Departmentof Neurology and Neurosciences, University of Medicineand Dentistry of New Jersey, Newark 07103, USA. ismailkhatri@yahoo.com
Mian
Nimer
N
Alkawi
Ammar
A
Janjua
Nazli
N
Kirmani
Jawad F
JF
Saric
Muhamed
M
Levine
Jason C
JC
Qureshi
Adnan I
AI
D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D001027:Aortography; D001161:Arteriosclerosis / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000473:pathology