title: Ischemic lesion burden and characteristics of aortic atheroma.
abstract: BACKGROUND
  To investigate whether ischemic lesion burden including lesion pattern, number, and volume would vary depending on risk stratification of aortic atheroma (AA).
  
  
  METHODS
  Acute stroke patients were enrolled if they had (1) acute ischemic lesions on diffusion-weighted imaging within 5 days of symptom onset, (2) cardioembolic stroke established through extensive workup, and (3) only ascending or arch AA detected by transesophageal echocardiography as an embolic source. AA was classified as complex (protruding ≥4 mm into the aortic lumen or any mobile or ulcerative component) or simple (<4 mm).
  
  
  RESULTS
  Eighty-one patients (male: 65.4% and age: 66.7 ± 11.0 years) were included in the study. Thirty-four patients (41.9%) had complex atheroma. These patients had a greater number of ischemic lesions (median: 2 lesions [range: 1-42] versus one lesion [range: 1-27], P = .017) and a larger infarct size (9.01 cc [range: 3.58-49.14] versus 4.6 cc [range: 2.3-13.28), P = .056) than the simple atheroma group. Multivariable logistic regression analysis showed that ischemic lesion volume was independently associated with complex atheroma (odds ratio: 1.03, 95% confidence interval: 1.002-2.148, P = .035), while multiple lesions were related (odds ratio: 3.03, 95% confidence interval: .88-10.42, P = .079).
  
  
  CONCLUSIONS
  Ischemic lesion burden in patients with AA differed according to AA characteristics, suggesting that the morphological features of AA could reflect an embolic potential of AA.
authors.affiliation: Department of Neurology, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Jin-Man
authors.initials: JM
authors.lastname: Jung
authors.affiliation: Department of Neurology, Seonam Hospital, Seoul, Korea.
authors.forename: Joo Y
authors.initials: JY
authors.lastname: Kwon
authors.affiliation: Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.
authors.forename: Hye-Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sun U
authors.initials: SU
authors.lastname: Kwon
authors.affiliation: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Song
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jong S
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea; Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: dwkang@amc.seoul.kr.
authors.forename: Dong-Wha
authors.initials: DW
authors.lastname: Kang
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology*; D016009:Chi-Square Distribution; D038524:Diffusion Magnetic Resonance Imaging; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology*
keywords: Ischemic stroke; aortic arch atherosclerosis