Cerebral microembolism and the risk of ischemia in asymptomatic high-grade internal carotid artery stenosis.

Abstract:

BACKGROUND AND PURPOSE:Previous work has shown that cerebral microembolism detected with transcranial Doppler sonography distal to internal carotid artery stenosis occurs more frequently in recently symptomatic compared with asymptomatic patients. It has remained unclear whether cerebral microembolism also indicates a higher risk of future cerebral or retinal ischemia. SUMMARY OF REPORT:Sixty-four asymptomatic patients with unilateral 70% to 90% internal carotid artery stenosis were investigated prospectively (mean follow-up, 72 weeks). Five patients developed ischemic symptoms attributable to the stenosis (transient ischemic attack, 2 patients; stroke, 3 patients). A microembolic rate of > or = 2 per hour in the ipsilateral middle cerebral artery was associated with a substantially increased risk of developing ischemia of the corresponding carotid territory (odds ratio, 31; 95% confidence interval, 3 to 302; P = .005). CONCLUSIONS:This prospective pilot study suggests that cerebral microembolism detected with transcranial Doppler sonography may define a high-risk subgroup among patients with asymptomatic high-grade internal carotid artery stenosis.

journal_name

Stroke

journal_title

Stroke

authors

Siebler M,Nachtmann A,Sitzer M,Rose G,Kleinschmidt A,Rademacher J,Steinmetz H

doi

10.1161/01.str.26.11.2184

subject

Has Abstract

pub_date

1995-11-01 00:00:00

pages

2184-6

issue

11

eissn

0039-2499

issn

1524-4628

journal_volume

26

pub_type

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