Viedma-Guiard Elena, Guidoux Celine, Amarenco Pierre, Meseguer Elena
Department of Neurology and Stroke Center, APHP Bichat Hospital, Paris, France Université de Paris, LVTS, Inserm U1148, Paris, France.
Front Neurol. 2021 Jan 15;11:606663. doi: 10.3389/fneur.2020.606663. eCollection 2020.
Aortic arch atheroma is a frequent finding in ischemic stroke patients. Its role as a source of cerebral emboli or a marker of atherosclerosis is unclear. Transesophageal echography is considered the gold standard for its detection, whereas computed tomography angiography is a good alternative; magnetic resonance and positron emission tomography could be proposed to better analyze plaque vulnerability. Despite the interest in this condition, the optimal antithrombotic treatment remains uncertain, while intensive lipid-lowering therapy should be recommended. This review aims to offer guidance on patients with aortic arch atheroma, about its causal role in stroke, diagnosis, and treatment based on current available evidence.
主动脉弓粥样硬化在缺血性中风患者中很常见。其作为脑栓塞来源或动脉粥样硬化标志物的作用尚不清楚。经食管超声心动图被认为是检测该病的金标准，而计算机断层血管造影是一种很好的替代方法；可采用磁共振成像和正电子发射断层扫描来更好地分析斑块易损性。尽管人们对这种情况很感兴趣，但最佳抗栓治疗仍不确定，而应推荐强化降脂治疗。本综述旨在根据现有证据，为主动脉弓粥样硬化患者在其与中风的因果关系、诊断和治疗方面提供指导。
