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Health Sciences · Medicine

Aortic Thrombus and Embolism
Research Guide

What is Aortic Thrombus and Embolism?

Aortic thrombus and embolism refers to the formation of thrombi or mobile plaques in the aorta, particularly from aortic atherosclerosis, that dislodge to cause embolic events such as ischemic stroke, renal disease, and peripheral arterial embolism.

The field encompasses 12,323 papers examining the link between aortic atherosclerosis and embolic complications including stroke and atheroembolic renal disease. Transesophageal echocardiography assesses aortic plaque morphology to predict embolic risk, while anticoagulation therapy is evaluated for management of mobile aortic thrombi. Diagnosis and treatment of cholesterol embolization syndrome and thoracic aorta plaques are central topics.

Topic Hierarchy

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graph TD D["Health Sciences"] F["Medicine"] S["Pulmonary and Respiratory Medicine"] T["Aortic Thrombus and Embolism"] D --> F F --> S S --> T style T fill:#DC5238,stroke:#c4452e,stroke-width:2px
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12.3K
Papers
N/A
5yr Growth
67.0K
Total Citations

Research Sub-Topics

Why It Matters

Aortic thrombus and embolism contribute to ischemic stroke, with Amarenco et al. (1994) demonstrating a strong independent association between aortic arch atherosclerotic disease and stroke risk, particularly with thick plaques exceeding 4 mm, in a study of 442 patients where such plaques increased odds by over fourfold. This impacts clinical practice by identifying aortic arch atherosclerosis as a key risk factor warranting targeted screening via transesophageal echocardiography. In renal disease, atheroembolic events from aortic plaques lead to cholesterol embolization syndrome, affecting patient management in vascular pathologies. Davies et al. (1993) linked plaque thrombosis risk to high extracellular lipid content and macrophage predominance, informing anticoagulation strategies for preventing peripheral embolism.

Reading Guide

Where to Start

"Atherosclerotic Disease of the Aortic Arch and the Risk of Ischemic Stroke" by Amarenco et al. (1994), as it provides foundational evidence of the direct link between aortic plaques and stroke risk with clear clinical data on plaque thickness.

Key Papers Explained

Amarenco et al. (1994) establishes aortic arch atherosclerosis as a stroke risk factor, which Davies et al. (1993) mechanistically supports by detailing plaque lipid and macrophage content driving thrombosis. Stary et al. (1995) classifies advanced atherosclerotic lesions, contextualizing aortic plaque types, while Hart et al. (2014) extends this to embolic stroke constructs potentially arising from aortic sources.

Paper Timeline

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graph LR P0["Risk of thrombosis in human athe...
1993 · 1.1K cites"] P1["Characterization of the early le...
1994 · 1.3K cites"] P2["Atherosclerotic Disease of the A...
1994 · 1.0K cites"] P3["Homocysteine and vascular disease
1999 · 1.0K cites"] P4["Cardiac calcification in adult h...
2002 · 1.1K cites"] P5["A Randomized Trial of Intensive ...
2005 · 1.1K cites"] P6["Embolic strokes of undetermined ...
2014 · 1.6K cites"] P0 --> P1 P1 --> P2 P2 --> P3 P3 --> P4 P4 --> P5 P5 --> P6 style P6 fill:#DC5238,stroke:#c4452e,stroke-width:2px
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Most-cited paper highlighted in red. Papers ordered chronologically.

Advanced Directions

Current focus remains on refining transesophageal echocardiography for mobile thrombus detection and anticoagulation optimization, as no recent preprints or news alter established associations from top papers like Amarenco et al. (1994) and Davies et al. (1993).

Papers at a Glance

# Paper Year Venue Citations Open Access
1 Embolic strokes of undetermined source: the case for a new cli... 2014 The Lancet Neurology 1.6K
2 Characterization of the early lesion of 'degenerative' valvula... 1994 Circulation 1.3K
3 Risk of thrombosis in human atherosclerotic plaques: role of e... 1993 Heart 1.1K
4 Cardiac calcification in adult hemodialysis patients 2002 Journal of the America... 1.1K
5 A Randomized Trial of Intensive Lipid-Lowering Therapy in Calc... 2005 New England Journal of... 1.1K
6 Homocysteine and vascular disease 1999 The Lancet 1.0K
7 Atherosclerotic Disease of the Aortic Arch and the Risk of Isc... 1994 New England Journal of... 1.0K
8 A Definition of Advanced Types of Atherosclerotic Lesions and ... 1995 Arteriosclerosis Throm... 946
9 Genetic Associations with Valvular Calcification and Aortic St... 2013 New England Journal of... 944
10 Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol 2019 New England Journal of... 744

Frequently Asked Questions

What is the association between aortic arch atherosclerosis and ischemic stroke?

Amarenco et al. (1994) found a strong independent association between atherosclerotic disease of the aortic arch and ischemic stroke risk in the New England Journal of Medicine. Thick plaques greater than 4 mm showed the strongest link. This positions aortic arch disease as a significant stroke risk factor.

How does plaque composition influence thrombosis risk in aortic atherosclerosis?

Davies et al. (1993) showed that thrombosis risk in human atherosclerotic plaques rises with high extracellular lipid volume and monocyte/macrophage predominance over smooth muscle cells in the cap. Aortic ulceration and thrombosis characterize such plaques. This composition predicts embolic potential.

What role does transesophageal echocardiography play in aortic thrombus diagnosis?

Transesophageal echocardiography evaluates aortic plaque morphology and mobile thrombi in the thoracic aorta to predict embolic risk. It identifies atheromatous plaques associated with cerebrovascular events. This imaging is key for assessing embolization potential.

What is cholesterol embolization syndrome in the context of aortic disease?

Cholesterol embolization syndrome arises from aortic atherosclerotic plaques dislodging to cause atheroembolic renal disease and peripheral embolism. It links to aortic atherosclerosis clusters. Management involves addressing underlying plaque instability.

How is anticoagulation therapy used for mobile aortic thrombi?

Anticoagulation therapy manages mobile thrombi in the thoracic aorta to reduce embolic events like stroke. Its role is discussed alongside plaque assessment via echocardiography. Efficacy depends on thrombus characteristics.

What defines embolic strokes related to aortic sources?

Hart et al. (2014) proposed embolic strokes of undetermined source as a clinical construct for strokes linked to potential aortic or cardiac emboli. This includes cases from aortic thrombi. It guides targeted anticoagulation trials.

Open Research Questions

  • ? What is the long-term efficacy of anticoagulation versus antiplatelet therapy in preventing embolism from mobile aortic thrombi?
  • ? How accurately does transesophageal echocardiography quantify embolic risk from specific aortic plaque morphologies?
  • ? Which plaque components most strongly predict progression to atheroembolic renal disease?
  • ? Can lipid-lowering therapies stabilize aortic plaques to reduce stroke incidence in high-risk populations?
  • ? What genetic factors influence aortic arch plaque thickness and embolic potential?

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