Coexisting large and small vessel disease in patients with ischemic stroke of undetermined cause.
OBJECTIVE
Large artery atherosclerosis (LAA) and small vessel disease (SVD) share common risk factors for stroke. We aimed at investigating the association of SVD with cerebral LAA as well as with atherosclerosis in patients with stroke likely to originate from aortic plaques.


METHODS
We investigated 71 consecutive patients (48 men, mean age 64.2 ± 13 years) with ischemic stroke of undetermined cause according to the ASCO classification, who received ECG-triggered CT angiography for best available atherosclerotic plaque detection in the aorta.


RESULTS
Aortic atherosclerotic plaques were detected in 54 patients (76.1%). The presence of SVD significantly correlated with the presence of aortic plaques (p < 0.001), as well as LAA (p < 0.001) and risk factors such as arterial hypertension (p = 0.032) and diabetes mellitus (p = 0.017).


CONCLUSIONS
Aortic plaques are common in patients with stroke of undetermined cause. If so, SVD and LAA are often coexisting, which demonstrates the close link of macro- and microangiopathy, at least in cases of severe risk factors of atherosclerosis.
Department of Neurology, UniversitätsMedizin Mannheim, University of Heidelberg, Mannheim, Germany. anastasios.chatzikonstantinou@umm.de
A
A
Chatzikonstantinou
R
R
Krissak
A
A
Schaefer
S O
SO
Schoenberg
C
C
Fink
M G
MG
Hennerici
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications* / Q000209:etiology; D014652:Vascular Diseases / Q000150:complications*