Complex aortic atheroma plaques: study of 71 patients with lacunar infarcts

Background and objectives: To characterize the frequency and the clinical factors of complex aortic atheroma plaques (CAA) in patients with a first-ever lacunar infarct (LI). Patients and methods: Sample of 71 consecutive patients with a first LI (9 of uncertain etiology) included in a stroke registry over a period of 4 years, studied by neuroimaging and suprasternal transthoracic echocardiography with harmonic imaging technology. We analyze the risk factors, clinical data and prognosis. Results: Echocardiography was abnormal in 20 patients (28.2%). Seven patients (9.9%) had simple aortic plaques and 13 (18.3%) had CAA. There were 10 women and 3 men of 79 (range 57-91) years of median age. Pure motor hemiparesis was the most common syndrome present in 5 cases (39%). Hypertension (69%). previous transient ischemic attack (39%) and diabetes (31%) were the main risk factors. Only 3 patients with CAA (4.2% of the total and 33% of LI of uncertain etiology) had no risk factors. Silent infarcts were present in 7 cases (53.8%) (6 LI and one non-LI). No patient died during hospitalization. Conclusions: The presence of complex aortic atheroma plaques was observed in 18.3% of first-LI patients, with a predominance of females. High risk criteria of aortic embolism was present in 4.2% of LI. CAA should be ruled out in essential LI patients. (C) 2011 Elsevier Espana, S.L. All rights reserved.