(Stroke. 1995;26:2184-2186.)
© 1995 American Heart Association, Inc.
Articles |
Cerebral Microembolism and the Risk of Ischemia in Asymptomatic High-Grade Internal Carotid Artery Stenosis
From the Department of Neurology, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany.
Correspondence to Dr Mario Siebler, Department of Neurology, Heinrich-Heine-Universität Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany.
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 
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.
Key Words: embolism • cerebral ischemia • carotid artery diseases • ultrasonics
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