<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-671X</journal-id>
<journal-title><![CDATA[Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Medicina Interna]]></abbrev-journal-title>
<issn>0872-671X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-671X2024000500016</article-id>
<article-id pub-id-type="doi">10.24950/rspmi.2426</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Desafio do Tratamento da Ateromatose Complexa da Aorta em Contexto de Acidente Vascular Cerebral Isquémico: Uma Análise Retrospetiva]]></article-title>
<article-title xml:lang="en"><![CDATA[Treatment Challenge of Complex Aortic Atherosclerosis in Acute Ischemic Stroke Context: A Retrospective Study]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz]]></surname>
<given-names><![CDATA[Daniela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sequeira]]></surname>
<given-names><![CDATA[Mafalda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ilchyshyn]]></surname>
<given-names><![CDATA[Nazar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pintassilgo]]></surname>
<given-names><![CDATA[Inês]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Garcia de Orta Unidade Local de Saúde de Almada-Seixal Serviço de Medicina Interna]]></institution>
<addr-line><![CDATA[Almada ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Garcia de Orta Unidade Local de Saúde de Almada-Seixal Serviço de Cardiologia]]></institution>
<addr-line><![CDATA[Almada ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<volume>31</volume>
<numero>4</numero>
<fpage>16</fpage>
<lpage>22</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-671X2024000500016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-671X2024000500016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-671X2024000500016&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A ateromatose complexa da aorta é uma causa importante de acidente vascular cerebral (AVC). Contudo, a falta de evidência científica leva a que o seu tratamento seja bastante controverso, tornando imperativa a realização de mais estudos. Este estudo pretende avaliar a eficácia e a segurança das várias estratégias terapêuticas utilizadas na ateromatose complexa da aorta.  Material e Métodos:  Foi realizada uma análise retrospetiva dos doentes internados por AVC isquémico com diagnóstico de ateromatose complexa da aorta por ecocardiograma transesofágico, entre 1 de janeiro de 2010 e 31 de dezembro de 2022.  Resultados:  Dos 82 doentes incluídos, 23,2% apresentaram recorrência de AVC isquémico, dos quais 47,4% estavam medicados com clopidogrel em monoterapia. Os doentes medicados com clopidogrel apresentaram maior recorrência de AVC isquémico (p &lt;0,001), enquanto doentes medicados com dupla antiagregação apresentaram menor recorrência (p = 0,035). Doentes medicados com anticoagulantes orais diretos não apresentaram recorrência. Dos doentes medicados com varfarina, cinco tiveram recorrência com INR infra-terapêutico e dois apresentaram eventos hemorrágicos.  Conclusão:  Na nossa população a utilização de dupla antiagregação com ácido acetilsalicílico e clopidogrel durante 3 a 6 meses seguido de antiagregação simples com ácido acetilsalicílico demonstrou ser a estratégia mais segura e eficaz no tratamento do AVC isquémico associado a ateromatose complexa da aorta, enquanto o uso de clopidogrel se associou a maior taxa de recorrência. Nos doentes com indicação para anticoagulação os anticoagulantes orais diretos pareceram ser eficazes e mais seguros do que a varfarina.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Complex aortic atherosclerosis is an important cause of stroke. However, the lack of scientific evidence makes its treatment controversial, which highlights the need for further research. This study aims to evaluate the efficacy and safety of the therapeutic strategies used in complex aortic atherosclerosis.  Material and Methods: A retrospective analysis was carried out on patients hospitalized with ischemic stroke and complex aortic atherosclerosis diagnosed by transesophageal echocardiography, between January 1, 2010 and December 31, 2022.  Results: Of the 82 patients included, 23.2% had ischemic stroke recurrence, of which 47.4% were treated with clopidogrel monotherapy. Patients taking clopidogrel had a higher ischemic stroke recurrence rate (p &lt;0.001), while patients taking dual antiplatelet therapy had a lower recurrence rate (p = 0.035). There was no recurrence in patients receiving direct oral anticoagulants. Regarding the patients treated with warfarin, five had recurrence with an infra-therapeutic INR and two had hemorrhagic events.  Conclusion: In our population, dual antiplatelet therapy with acetylsalicylic acid and clopidogrel for 3 to 6 months followed by single antiplatelet therapy with acetylsalicylic acid seems to be the safest and most effective strategy for the treatment of ischemic stroke associated with complex aortic atherosclerosis, while clopidogrel monotherapy was associated with a higher recurrence rate. Direct oral anticoagulants appeared to be effective and safer than warfarin for patients receiving anticoagulant therapy.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Acidente Vascular Cerebral]]></kwd>
<kwd lng="pt"><![CDATA[Aorta Torácica]]></kwd>
<kwd lng="pt"><![CDATA[Aterosclerose]]></kwd>
<kwd lng="pt"><![CDATA[Fatores de Risco de Doenças Cardíacas]]></kwd>
<kwd lng="pt"><![CDATA[Isquemia.]]></kwd>
<kwd lng="en"><![CDATA[Aorta, Thoracic]]></kwd>
<kwd lng="en"><![CDATA[Atherosclerosis]]></kwd>
<kwd lng="en"><![CDATA[Heart Disease Risk Factors]]></kwd>
<kwd lng="en"><![CDATA[Ischemia]]></kwd>
<kwd lng="en"><![CDATA[Stroke.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kronzon]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Tunick]]></surname>
<given-names><![CDATA[PA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aortic atherosclerotic disease and stroke]]></article-title>
<source><![CDATA[Circulation]]></source>
<year>2006</year>
<volume>114</volume>
<page-range>63-75</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Matsuzaki]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ono]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tomochika]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Michishige]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Tanaka]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Okuda]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Advances in transesophageal echocardiography for the evaluation of atherosclerotic lesions in thoracic aorta-the effects of hypertension, hypercholesterolemia, and aging on atherosclerotic lesions]]></article-title>
<source><![CDATA[Jpn Circ J]]></source>
<year>1992</year>
<volume>56</volume>
<page-range>592-602</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Di Tullio]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Homma]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Jin]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Sacco]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aortic atherosclerosis, hypercoagulability, and stroke the APRIS (Aortic Plaque and Risk of Ische-mic Stroke) study]]></article-title>
<source><![CDATA[J Am Coll Cardiol]]></source>
<year>2008</year>
<volume>52</volume>
<page-range>855-61</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tzourio]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bertrand]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Chauvel]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bousser]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Amarenco]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aortic plaque morphology and vascular events a follow-up study in patients with ischemic stroke. FAPS Investigators. French Study of Aortic Plaques in Stroke]]></article-title>
<source><![CDATA[Circulation]]></source>
<year>1997</year>
<volume>96</volume>
<page-range>3838-41</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tunick]]></surname>
<given-names><![CDATA[PA]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenzweig]]></surname>
<given-names><![CDATA[BP]]></given-names>
</name>
<name>
<surname><![CDATA[Katz]]></surname>
<given-names><![CDATA[ES]]></given-names>
</name>
<name>
<surname><![CDATA[Freedberg]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Perez]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Kronzon]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High risk for vascular events in patients with protruding aortic atheromas a prospective study]]></article-title>
<source><![CDATA[J Am Coll Cardiol]]></source>
<year>1994</year>
<volume>23</volume>
<page-range>1085-90</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[EF]]></given-names>
</name>
<name>
<surname><![CDATA[Kalman]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Calafiore]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Tonkin]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Donnan]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Proximal aortic atheroma An independent risk factor for cerebral ischemia]]></article-title>
<source><![CDATA[Stroke]]></source>
<year>1995</year>
<volume>26</volume>
<page-range>218-24</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amarenco]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tzourio]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bertrand]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Hommel]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Besson]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atherosclerotic disease of the aortic arch and the risk of ischemic stroke]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>1994</year>
<volume>331</volume>
<page-range>1474-9</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amarenco]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Duyckaerts]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Tzourio]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hénin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Bousser]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Hauw]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The prevalence of ulcerated plaques in the aortic arch in patients with stroke]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>1992</year>
<volume>326</volume>
<page-range>221-5</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amarenco]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Davis]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Jones]]></surname>
<given-names><![CDATA[EF]]></given-names>
</name>
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Heiss]]></surname>
<given-names><![CDATA[WD]]></given-names>
</name>
<name>
<surname><![CDATA[Kaste]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clopidogrel plus aspirin versus warfarin in patients with stroke and aortic arch plaques]]></article-title>
<source><![CDATA[Stroke]]></source>
<year>2014</year>
<volume>45</volume>
<page-range>1248-57</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Andersen]]></surname>
<given-names><![CDATA[KK]]></given-names>
</name>
<name>
<surname><![CDATA[Olsen]]></surname>
<given-names><![CDATA[TS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The obesity paradox in stroke lower mortality and lower risk of readmission for recurrent stroke in obese stroke patients]]></article-title>
<source><![CDATA[Int J Stroke]]></source>
<year>2015</year>
<volume>10</volume>
<page-range>99-104</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Doehner]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Schenkel]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Anker]]></surname>
<given-names><![CDATA[SD]]></given-names>
</name>
<name>
<surname><![CDATA[Springer]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Audebert]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Overweight and obesity are associated with improved survival, functional outcome, and stroke recurrence after acute stroke or transient ischaemic attack observations from the TEMPiS trial]]></article-title>
<source><![CDATA[Eur Heart J]]></source>
<year>2013</year>
<volume>34</volume>
<page-range>268-77</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Han]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gu]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association of BMI with total mortality and recurrent stroke among stroke patients A meta-analysis of cohort studies]]></article-title>
<source><![CDATA[Atherosclerosis]]></source>
<year>2016</year>
<volume>253</volume>
<page-range>94-101</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chaudhary]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Khan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Abedi]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Zand]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Obesity and mortality after the first ischemic stroke Is obesity paradox real?]]></article-title>
<source><![CDATA[PLoS One]]></source>
<year>2021</year>
<volume>16</volume>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Harloff]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Strecker]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Reinhard]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kollum]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Handke]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Olschewski]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Combined measurement of carotid stiffness and intima-media thickness improves prediction of complex aortic plaques in pa-tients with ischemic stroke]]></article-title>
<source><![CDATA[Stroke]]></source>
<year>2006</year>
<volume>37</volume>
<page-range>2708-12</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Suzuki]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Furuya]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Ozawa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Miura]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Ozawa]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Matsuzono]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Complex Aortic Arch Atherosclerosis in Acute Ischemic Stroke Patients with Non-Valvular Atrial Fibrillation]]></article-title>
<source><![CDATA[J Atheroscler Thromb]]></source>
<year>2021</year>
<volume>28</volume>
<page-range>776-85</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amarenco]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Duyckaerts]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Tzourio]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hénin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Bousser]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Hauw]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The prevalence of ulcerated plaques in the aortic arch in patients with stroke]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>1992</year>
<volume>326</volume>
<page-range>221-5</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Arun]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Nambiar]]></surname>
<given-names><![CDATA[PN]]></given-names>
</name>
<name>
<surname><![CDATA[Kannath]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Sreedharan]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Sukumaran]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sarma]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neurol]]></article-title>
<source><![CDATA[India]]></source>
<year>2022</year>
<volume>70</volume>
<page-range>182-7</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Anan]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Mashiko]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Matsuzono]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Miura]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Ozawa]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Suzuki]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coexisting of aortic arch atheroma and atrial fibrillation for short-term recurrence and poor functional outcome in acute stroke]]></article-title>
<source><![CDATA[Neurol Sci]]></source>
<year>2022</year>
<volume>43</volume>
<page-range>2387-96</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kleindorfer]]></surname>
<given-names><![CDATA[DO]]></given-names>
</name>
<name>
<surname><![CDATA[Towfighi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Chaturvedi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Cockroft]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Gutierrez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Lombardi-Hill]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack A Guideline From the American Heart Association/American Stroke Association]]></article-title>
<source><![CDATA[Stroke]]></source>
<year>2021</year>
<volume>52</volume>
<page-range>e364-467</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Johnston]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Easton]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Farrant]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Barsan]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Conwit]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Elm]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2018</year>
<volume>379</volume>
<page-range>215-25</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Di Tullio]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Russo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Jin]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Sacco]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Mohr]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Homma]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aortic arch plaques and risk of recurrent stroke and death]]></article-title>
<source><![CDATA[Circulation]]></source>
<year>2009</year>
<volume>119</volume>
<page-range>2376-82</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Paciaroni]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ince]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Jeng]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Kutluk]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Benefits and Risks of Clopidogrel vs Aspirin Monotherapy after Recent Ischemic Stroke: A Systematic Review and Meta-Analysis.]]></article-title>
<source><![CDATA[Cardiovasc Ther]]></source>
<year>2019</year>
<volume>2019</volume>
<page-range>1607181</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Coull]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lovett]]></surname>
<given-names><![CDATA[JK]]></given-names>
</name>
<name>
<surname><![CDATA[Rothwell]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Population based study of early risk of stroke after transient ischaemic attack or minor stroke implications for public education and organisation of services.]]></article-title>
<collab>Oxford Vascular Study</collab>
<source><![CDATA[BMJ]]></source>
<year>2004</year>
<volume>328</volume>
<page-range>326</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Pan]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Johnston]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clopidogrel With Aspirin in Acute Minor Stroke or Transient Ischemic Attack (CHANCE) Trial One-Year Outcomes]]></article-title>
<source><![CDATA[Circulation]]></source>
<year>2015</year>
<volume>132</volume>
<page-range>40-6</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lun]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Dhaliwal]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Zitikyte]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Roy]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Hutton]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Dowlatshahi]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparison of Ticagrelor vs Clopidogrel in Addition to Aspirin in Patients With Minor Ischemic Stroke and Transient Ischemic Attack A Network Meta-analysis]]></article-title>
<source><![CDATA[JAMA Neurol]]></source>
<year>2022</year>
<volume>79</volume>
<page-range>141-8</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Efficacy and safety of clopidogrel and/or aspirin for ischemic stroke/transient ischemic attack An overview of systematic reviews and meta-analysis]]></article-title>
<source><![CDATA[Medicine]]></source>
<year>2021</year>
<volume>100</volume>
</nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kaneko]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Saito]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Sasaki]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Sugawara]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Akasaka]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kanaya]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rosuvastatin prevents aortic arch plaque progression and improves prognosis in ischemic stroke patients]]></article-title>
<source><![CDATA[Neurol Res]]></source>
<year>2017</year>
<volume>39</volume>
<page-range>133-41</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
