ARTERIOSCLEROSIS OF THE THORACIC AORTA AS A SOURCE OF SYSTEMIC EMBOLI- A CLINICOPATHOLOGICAL STUDY

The significance of the thoracic aorta as a source of systemic emboli in addition to other sources of embolism remains unexplained. A study of 120 consecutive necropsies (65 men, 55 women: mean age 71 [29-94] y ears) analysed the possible correlation of the severity of arterioscle rosis of the aorta, the carotid arteries and the arteries at the base of the brain as well as cardiac changes, with potential sources of emb oli and with proven emboli (n = 39). Complex and fibrous plaques in th e arch of the aorta, ipsilateral carotid artery stenoses, a history of atrial fibrillation and heart weight correlated significantly with em boli on both uni- and multivariant analysis. But the presence of calci fied and complex plaques in the descending aorta, as well as moderate and severe arteriosclerosis in the arteries at the base of the brain, correlated significantly only on univariant analysis. Ischaemic brain lesions had been clinically silent in twelve of 32 cases, while viscer al emboli had been silent in nine out of ten cases. - It is concluded from these data that, in addition to the cardiac chambers and arterios clerosis of the arteries at the base of the brain, advanced arterioscl erosis of the aortic arch is an important source of systemic emboli. A s many of the emboli remain silent, their incidence is probably undere stimated clinically.