{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T13:33:24Z","timestamp":1777124004326,"version":"3.51.4"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2004,6]]},"abstract":"\n \n Background and Purpose\u2014<\/jats:italic>\n <\/jats:bold>\n Aortic arch atherosclerotic lesions are often associated with embolic brain infarction. We investigated the relationship between stroke recurrence and the characteristics of aortic arch atherosclerotic lesions.\n <\/jats:p>\n \n \n Methods\u2014<\/jats:italic>\n <\/jats:bold>\n Among 487 stroke patients who underwent transesophageal echocardiography, 283 patients with brain embolism diagnosed without significant occlusive lesions (\u226550%) in their cerebral arteries were included in this study. We measured the intima-media thickness (IMT) and evaluated the extension and mobility of the aortic arch atherosclerotic lesions. During a mean follow-up period of 3.4 years, we investigated the relationship between stroke recurrence and the various characteristics of the aortic arch atherosclerotic lesions.\n <\/jats:p>\n \n \n Results\u2014<\/jats:italic>\n <\/jats:bold>\n An IMT \u22654.0 mm was found in 67 patients (25.3%). In 51 of these patients, the aortic lesions extended to the origin of the branches of the arch. Recurrences of cerebral ischemic events were found in 32 patients (recurrence group) and not in the other 251 (nonrecurrence group). Aortic atheroma \u22654.0 mm (41% versus 22%), aortic atheroma extending to the branches (63% versus 39%), and both (38% versus 16%) were more frequently seen in the recurrence group than in the nonrecurrence group (\n P<\/jats:italic>\n <0.05,\n P<\/jats:italic>\n <0.1,\n P<\/jats:italic>\n <0.01, respectively). After adjustment for age and the presence of hypertension, an aortic atheroma that was \u22654.0 mm as well as extending to the branches was found to be an independent predictor of ischemic stroke recurrence (hazard ratio=2.42,\n P<\/jats:italic>\n <0.05).\n <\/jats:p>\n \n \n Conclusions\u2014<\/jats:italic>\n <\/jats:bold>\n Stroke recurrence is associated with the severity of the atheroma (IMT \u22654.0 mm) and plaque extension to the branches.\n <\/jats:p>","DOI":"10.1161\/01.str.0000127788.32550.d4","type":"journal-article","created":{"date-parts":[[2004,5,4]],"date-time":"2004-05-04T00:49:25Z","timestamp":1083631765000},"page":"1426-1429","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":76,"title":["Aortic Arch Atherosclerotic Lesions and the Recurrence of Ischemic Stroke"],"prefix":"10.1161","volume":"35","author":[{"given":"Shigeru","family":"Fujimoto","sequence":"first","affiliation":[{"name":"From the Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Yasaka","sequence":"additional","affiliation":[{"name":"From the Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoichi","family":"Otsubo","sequence":"additional","affiliation":[{"name":"From the Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Oe","sequence":"additional","affiliation":[{"name":"From the Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuyuki","family":"Nagatsuka","sequence":"additional","affiliation":[{"name":"From the Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuo","family":"Minematsu","sequence":"additional","affiliation":[{"name":"From the Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90706-F"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-115-6-423"},{"key":"e_1_3_2_3_2","first-page":"239","volume":"124","year":"1992","unstructured":"Tunick PA, Lackner H, Katz ES, Culliford AT, Giangola G, Kronzon I. Multiple emboli from a large aortic arch thrombus in a patient with thrombotic diathesis. Am Heart J. 1992; 124: 239\u2013241.","journal-title":"Am Heart J"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90139-E"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.23.7.1615532"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.42.8.1602"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.23.8.1636177"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199201233260402"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199412013312202"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199605093341902"},{"key":"e_1_3_2_11_2","first-page":"218","volume":"26","year":"1995","unstructured":"Jones EF, Kalman JM, Calafiore P, Tonkin AM, Donnan GA. Proximal aortic atheroma: an independent risk factor for cerebral ischemia. Stroke. 1995; 26: 218\u2013224.","journal-title":"Stroke"},{"key":"e_1_3_2_12_2","first-page":"308.","volume":"29","year":"1998","unstructured":"Otsubo R, Yasaka M, Nagatsuka K, Minematsu K, Yamaguchi T. The role of the aortic arch atherosclerosis in embolic stroke. Stroke. 1998; 29: 308. Abstract.","journal-title":"Stroke"},{"key":"e_1_3_2_13_2","first-page":"63","volume":"97","year":"1998","unstructured":"Mendel T, Pasierski T, Szwed H, Baranska-Gieruszczak M, Czlonkowska A. Transesophageal echocardiographic findings in patients with anterior and posterior circulation infarcts. Acta Neurol Scand. 1998; 97: 63\u201367.","journal-title":"Acta Neurol Scand"},{"key":"e_1_3_2_14_2","first-page":"326.","volume":"31","year":"2000","unstructured":"Otsubo R, Morishita T, Yasaka M, Nagatsuka K, Minematsu K, Yamaguchi T. Effect of aortic atherosclerosis on hemostatic markers in patients with ischemic stroke. Stroke. 2000; 31: 326. Abstract.","journal-title":"Stroke"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.0000127788.32550.d4","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T21:51:35Z","timestamp":1715550695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.0000127788.32550.d4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,6]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2004,6]]}},"alternative-id":["10.1161\/01.STR.0000127788.32550.d4"],"URL":"https:\/\/doi.org\/10.1161\/01.str.0000127788.32550.d4","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,6]]},"assertion":[{"value":"2004-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2004-03-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2004-04-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}