Determinants of Micro-embolic Signals in Patients with Atherosclerotic Plaques of the Internal Carotid Artery

• Published in: European journal of vascular and endovascular surgery Vol. 38; no. 2; pp. 143 - 147
• Main Authors: Telman, G, Kouperberg, E, Hlebtovsky, A, Sprecher, E, Hoffman, A, Beyar, R
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2009
• Subjects: Adult; Aged; Aged, 80 and over; Carotid Artery, Internal - diagnostic imaging; Carotid plaque; Carotid Stenosis - complications; Carotid Stenosis - diagnostic imaging; Female; Humans; Intracranial Embolism - diagnostic imaging; Intracranial Embolism - etiology; Ischemic Attack, Transient - diagnostic imaging; Ischemic Attack, Transient - etiology; Logistic Models; Male; Middle Aged; Monitoring; Predictive Value of Tests; Prospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Stroke - diagnostic imaging; Stroke - etiology; Surgery; Symptomatic; Time Factors; Ultrasonography, Doppler, Transcranial; Ultrasound; Carotid plaque; Symptomatic; Ultrasound; Monitoring
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2009.03.019

Abstract Background and purpose This study aimed to investigate the embolic potential of carotid plaques, employing both the presence and the rate of micro-embolic signals (MESs), based on the presence and timing (current or past) of symptoms, degree of stenosis and ultrasonic characteristics of plaques. Methods We used the transcranial Doppler (TCD) to monitor MES and the Doppler ultrasound to classify carotid plaques in newly symptomatic (acute stroke or transient ischaemic attack (TIA)), formerly symptomatic (relevant stroke or TIA per anamnesis) and asymptomatic patients with internal carotid artery (ICA) stenosis. Results Stroke-related arteries evidenced a significantly greater presence of MES than the TIA-related and asymptomatic arteries ( p = 0.04), with no significant difference found between the latter two groups (stroke: 42/90, 46.7%; TIA: 15/49, 30.6%; asymptomatic: 40/130, 30.8%). Adjustment for anti-platelet treatment did not change this finding. The degree of stenosis, ultrasonic characteristics of texture and the density of plaques were not found to be associated with the presence or quantity of MES. Conclusion MESs are present significantly more often in stenosed, stroke-related carotid arteries as compared with TIA-related or asymptomatic arteries. Neither the ultrasonic characteristics nor the degree of stenosis were found to influence the presence or rate of MES.