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Atherosclerotic plaques of the aortic arch are an important cause of cerebral emboli. Aortic atheromas are diagnosed by transesophageal echocardiography. Since the thickness and morphologic characteristics of the plaques are usually correlated with the probability of an embolic event, an appropriate quantitative grading system is of prime importance. In 1999, Ferrari and coworkers1 confirmed the high incidence of vascular events in
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