Peripheral embolism resulting from unsuspected atheromatous aortic plaques.

Three cases of peripheral embolism resulting from atheromatous aortic plaques are reported. Although the majority of arterial thromboemboli are believed to have originated from mural thrombi within one of the cardiac chambers, there is reason to believe that embolism from atheromatous material within a major artery may occur more often than is represented in current literature. Successful management of this condition will necessitate (1) clinical awareness, (2) careful scrutinization of material recovered from embolectomy, (3) angiography to demonstrate the embolic source in the aorta or its main braches, and (4) appropriate remedy by either endarterectomy or graft replacement of the diseased artery segment. The pitfalls in the diagnosis of this condition are discussed.