Atheromas

An atheroma is furring-up of the interior of an artery by deposits, mainly of cholesterol, within its walls. Associated with atherosclerosis, atheroma has the effect of narrowing the lumen (channel) of the artery, thus restricting blood flow. This predisposes to a number of conditions, including thrombosis, angina and stroke

Protruding atheromas in the aortic arch has been recognized as a potential cause of cerebral stroke

• Several case-control studies with either autopsy findings or transesophageal echocardiography have identified large atheromas (ie, >4 mm in thickness) as one of the most powerful independent risk factors for ischemic stroke in patients >60 years of age
• High recurrence rate of cerebral or peripheral emboli in patients with protruding atheromas of the aortic arch identified by transesophageal echocardiography
• The risk of ischemic stroke mainly has been related to the thickness of the atheroma, with 4 mm or 5 mm most commonly used in the literature as a threshold of increased risk
• The complexity of the atheroma (the presence of ulcerations on its luminal surface or of mobile components) has been considered as a potential cofactor in further enhancing stroke risk, but its separate impact on stroke risk has begun to be recognized only recently

Atheromas are diagnosed with transesophageal echocardiography

References

DiTullio, Sacco, et al Aortic Atheroma Morphology and the Risk of Ischemic Stroke in a Multiethnic Population Am Heart J 139(2):329-336, 2000