[Complex aortic atheroma plaques: study of 71 patients with lacunar infarcts].
OBJECTIVE
To characterize the frequency and the clinical factors of complex aortic atheroma plaques (CAA) in patients with a first-ever lacunar infarct (LI).


METHODS
Sample of 71 consecutive patients with a first LI (9 of uncertain etiology) included in a stroke registry over a period of 4 years, studied by neuroimaging and suprasternal transthoracic echocardiography with harmonic imaging technology. We analyze the risk factors, clinical data and prognosis.


RESULTS
Echocardiography was abnormal in 20 patients (28.2%). Seven patients (9.9%) had simple aortic plaques and 13 (18.3%) had CAA. There were 10 women and 3 men of 79 (range 57-91) years of median age. Pure motor hemiparesis was the most common syndrome present in 5 cases (39%). Hypertension (69%), previous transient ischemic attack (39%) and diabetes (31%) were the main risk factors. Only 3 patients with CAA (4.2% of the total and 33% of LI of uncertain etiology) had no risk factors. Silent infarcts were present in 7 cases (53.8%) (6 LI and one non-LI). No patient died during hospitalization.


CONCLUSIONS
The presence of complex aortic atheroma plaques was observed in 18.3% of first-LI patients, with a predominance of females. High risk criteria of aortic embolism was present in 4.2% of LI. CAA should be ruled out in essential LI patients.
Unidad de Enfermedades Vasculares Cerebrales, Servicio de Neurología, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, España. aarboix@hscor.com
Adrià
A
Arboix
Maria
M
Rexach
Marta
M
Subirà
Ramon
R
Pujadas
D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000473:pathology*; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D059409:Stroke, Lacunar / Q000175:diagnosis / Q000209:etiology*