This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stygall, J. Articles by Newman, S. P. Search for Related Content PubMed PubMed Citation Articles by Stygall, J. Articles by Newman, S. P. Related Collections Coronary imaging: angiography/ultrasound/Doppler/CC Arrhythmias, clinical electrophysiology, drugs Doppler ultrasound, Transcranial Doppler etc.

(Stroke. 2000;31:2508.)
© 2000 American Heart Association, Inc.

Short Communication

Cerebral Microembolism Detected by Transcranial Doppler During Cardiac Procedures

Jan Stygall, MSc; Robert Kong, FRCA; J. Malcolm Walker, MD, FRCP; Suzanna M. C. Hardman, PhD, FRCP; Michael J. G. Harrison, DM, FRCP Stanton P. Newman, DPhil, Dip Psych

From the Departments of Neurological Studies (M.J.G.H), Psychiatry and Behavioral Sciences (J.S., R.K., S.P.N.), and Clinical and Academic Department of Cardiovascular Medicine (J.M.W., S.M.C.H.), University College London Hospitals and Medical School, London, UK.

Correspondence to Professor M.J.G. Harrison, Department of Neurological Studies, Middlesex Hospital, Mortimer St, London, W1N 8AA, UK. E-mail m.harrison{at}ucl.ac.uk

Abstract

Background and Purpose—Cerebral embolism with clinical sequelae may rarely complicate cardioversion and cardiac catheterization. Transcranial Doppler sonography has recently been introduced to monitor microemboli entering the middle cerebral artery in cardiac and carotid surgery. We therefore used this technique to evaluate the risk of asymptomatic embolism during common cardiac procedures.

Methods—Patients were monitored by transcranial Doppler while undergoing direct current cardioversion (n=15) and cardiac catheterization (n=17).

Results—Microemboli were detected in all patients having cardiac catheterization but in only 1 patient after cardioversion.

Conclusions—Microembolism occurred frequently during cardiac catheterization and rarely during cardioversion. It is not yet known whether this has clinical relevance.

Key Words: cardiac catheterization • cardioversion • embolism • ultrasonography, Doppler, transcranial

This article has been cited by other articles:

				J. K. White, A. Jagannath, J. Titus, R. Yoneyama, J. Madsen, and A. K. Agnihotri Funnel-tipped aortic cannula for reduction of atheroemboli. Ann. Thorac. Surg., August 1, 2009; 88(2): 551 - 557. [Abstract] [Full Text] [PDF]

				R. Dittrich and E. B. Ringelstein Occurrence and Clinical Impact of Microembolic Signals During or After Cardiosurgical Procedures Stroke, February 1, 2008; 39(2): 503 - 511. [Abstract] [Full Text] [PDF]

				P. Bahrmann, G. S. Werner, G. Heusch, M. Ferrari, T. C. Poerner, A. Voss, and H. R. Figulla Detection of Coronary Microembolization by Doppler Ultrasound in Patients With Stable Angina Pectoris Undergoing Elective Percutaneous Coronary Interventions Circulation, February 6, 2007; 115(5): 600 - 608. [Abstract] [Full Text] [PDF]

				L. A. Steiner and P. J. D. Andrews Monitoring the injured brain: ICP and CBF Br. J. Anaesth., July 1, 2006; 97(1): 26 - 38. [Abstract] [Full Text] [PDF]

				P Bahrmann, H R Figulla, M Wagner, M Ferrari, A Voss, and G S Werner Detection of coronary microembolisation by Doppler ultrasound during percutaneous coronary interventions Heart, September 1, 2005; 91(9): 1186 - 1192. [Abstract] [Full Text] [PDF]

				K. A. Busing, C. Schulte-Sasse, S. Fluchter, T. Suselbeck, K. K. Haase, W. Neff, J. G. Hirsch, M. Borggrefe, and C. Duber Cerebral Infarction: Incidence and Risk Factors after Diagnostic and Interventional Cardiac Catheterization--Prospective Evaluation at Diffusion-weighted MR Imaging Radiology, April 1, 2005; 235(1): 177 - 183. [Abstract] [Full Text] [PDF]

				M. F. Newman, J. A. Blumenthal, and D. B. Mark Fixing the Heart: Must the Brain Pay the Price? Circulation, November 30, 2004; 110(22): 3402 - 3403. [Full Text] [PDF]

				M. Bendszus, M. Koltzenburg, A. J. Bartsch, R. Goldbrunner, T. Gunthner-Lengsfeld, F. X. Weilbach, K. Roosen, K. V. Toyka, and L. Solymosi Heparin and Air Filters Reduce Embolic Events Caused by Intra-Arterial Cerebral Angiography: A Prospective, Randomized Trial Circulation, October 12, 2004; 110(15): 2210 - 2215. [Abstract] [Full Text] [PDF]

				D. B. Mark and M. F. Newman Protecting the Brain in Coronary Artery Bypass Graft Surgery JAMA, March 20, 2002; 287(11): 1448 - 1450. [Full Text] [PDF]