Ultrasound Examination of the Aortic Arch in Stroke

Introduction

The presence of protruding or ulcerated atheromas in the proximal segment of the aorta is associated with an increased frequency of peripheral or cerebral embolic events . The association, initially recognized in pathology studies , was confirmed in vivo with the introduction of transesophageal echocardiography (TEE), which rapidly became the diagnostic test of choice for detecting proximal aortic atheromas. TEE has allowed an accurate visualization of the proximal portion of the aorta and provided further evidence linking aortic atheromas with embolic events in numerous case–control, cross-sectional, and prospective cohort studies. This chapter discusses the technical aspects of the use of TEE for the detection of proximal aortic atheromas, a brief overview of the role of these atheromas as a risk factor for ischemic stroke, and some considerations regarding the measures to prevent recurrent embolic events.

Transesophageal Echocardiography