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Objectives: Arterial wall changes such as stiffening and thickening are important components of atherosclerosis. Understanding of the relationship between stiffening and thickening of the large arteries might helpful for the prevention of cerebrovascular disease. So, we investigated the relationship between carotid and aortic wall changes from assessed by the ankle-brachial pulse wave velocity and beta index from aorta in ischemic stroke.Subjects and Methods: Total 400 patients with ischemic stroke were classified four groups by carotid plaque. Group I; absence plaque (n=220), group II; small sized (<2cm) soft plaque (n=43), group III; large sized (>2cm) soft plaque (n=69), group IV; calcified or multiple large plaque (n=68). Each group was compared with ankle-brachial pulse wave velocity and beta index from descending thoracic aorta. Carotid and descending aortic intima-media thickness was also compared.Results: Carotid plaque and intima-media thickness were significantly associated with pulse wave velocity and beta index (p<0.05). High pulse wave velocity was independently associated with presence of carotid plaques (right: ß=0.959, p=0.018; left: ß =0.907 p=0.033), but there was not independently associated with the extent of the plaque in multivariate logistic regression analysis.Conclusion: This study shows that the pulse wave velocity is associated with the presence of carotid atherosclerosis, but not with the extent of carotid atherosclerosis in patients with ischemic stroke.