Objectives - To examine the thoracic aorta of patients with severe cho
lesterol embolism (CE) by transoesophageal echocardiography (TOE). Met
hods - The thoracic aorta of 20 consecutive patients with CE was compa
red with that in a control population matched for age and risk factors
by TOE. Patients were prescribed steroids after CE was diagnosed. Fol
low up is reported and compared with results in the literature. Result
s - Aortic plaques and debris were more common in patients with CE tha
n in the control population (p < 0.001 and p < 0.0001, respectively).
The mean (SD) number of aortic plaques in the CE patients was 2.6 (0.7
). This aortic atheroma was found predominantly in the descending aort
a. One patient died during a mean (SD) follow up of 24 (10) months. Co
nclusions - Aortic atheroma, as detected by TOE, should be considered
as the main source of CE. In addition, the prognosis in our series, in
which steroids were systematically prescribed, is much better than in
others reported in the literature.