Ntaios G, Pearce LA, Meseguer E, et al. - In this exploratory analysis of NAVIGATE ESUS (New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source), researchers sought to concentrate on patients with aortic arch atherosclerosis (AAA) and evaluate their features, stroke recurrence rates, and response to treatment. The study sample consisted of 1,382 participants who had transesophageal echocardiography. Data reported that 397 (29%) had AAA and 112 (8%) had complex AAA. According to multivariable analyses, increasing age, diabetes mellitus, aortic valvulopathy, statin use before randomization, chronic infarcts on imaging, and region were independently linked to any AAA vs no AAA and also with complex AAA vs no AAA. Investigators found that complex AAA is common in embolic stroke of undetermined source patients and is linked to atherosclerotic burden. Whether complex AAA independently raises the risk of recurrent stroke and whether a non-vitamin-K oral anticoagulant may be effective for decreasing recurrent stroke as compared with aspirin needs further study.