A 76-year-old woman presented with multiple brain infarctions in the right middle cerebral artery and vertebral artery area. Carotid sonography revealed a large mobile pedunculated mass in the brachiocephalic artery, which showed rapid growth despite treatment with heparin and aspirin. Graft replacement of the brachiocephalic artery was performed under selective cerebral perfusion with deep hypothermia. Histology of the resected specimen revealed aortic atherosclerotic plaque.
Get full access to this article
View all access options for this article.
References
1.
KronzonITunickPA. Aortic atherosclerotic disease and stroke [Review]. Circulation2006;114:63–75.
2.
FujimotoSYasakaMOtsuboROeHNagatsukaKMinematsuK. Aortic arch atherosclerotic lesions and the recurrence of ischemic stroke. Stroke2004;35:1426–9.
3.
AmarencoPCohenATzourioCBertrandBHommelMBessonG. Atherosclerotic disease of the aortic arch and the risk of ischemic stroke. N Engl J Med1994;331:1474–9.
4.
Atherosclerotic disease of the aortic arch as a risk factor for recurrent ischemic stroke. The French Study of Aortic Plaques in Stroke Group. N Engl J Med1996;334:1216–21.
5.
DresslerFACraigWRCastelloRLabovitzAJ. Mobile aortic atheroma and systemic emboli: Efficacy of anticoagulation and influence of plaque morphology on recurrent stroke. J Am Coll Cardiol1998;31:134–8.
6.
FerrariEVidalRChevallierTBaudouyM. Atherosclerosis of the thoracic aorta and aortic debris as a marker of poor prognosis: Benefit of oral anticoagulants. J Am Coll Cardiol1999;33:1317–22.
7.
GouëfficYChaillouPPilletJCDuveauDPatraP. Surgical treatment of nonaneurysmal aortic arch lesions in patients with systemic embolization. J Vasc Surg2002;36:1186–93.
8.
LancasterGLovoulosCJMoussouttasMGoldsteinAHLeiferDFayadPB. Aortic arch replacement for recurrent cerebral embolization. Ann Thorac Surg2002;73:291–4.
