This Article Full Text Full Text (PDF) All Versions of this Article: 36/8/1726    most recent 01.STR.0000173402.88560.aev1 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 Mackinnon, A. D. Articles by Markus, H. S. Search for Related Content PubMed PubMed Citation Articles by Mackinnon, A. D. Articles by Markus, H. S. Pubmed/NCBI databases Medline Plus Health Information Stroke Related Collections Carotid Stenosis Embolic stroke Doppler ultrasound, Transcranial Doppler etc.

(Stroke. 2005;36:1726.)
© 2005 American Heart Association, Inc.

Original Contributions

Ambulatory Transcranial Doppler Cerebral Embolic Signal Detection in Symptomatic and Asymptomatic Carotid Stenosis

From the Department of Clinical Neurosciences (A.D.M., H.S.M.), St Georges Hospital Medical School, London, United Kingdom; and Hemodynamics AG (R.A.), Berne, Switzerland.

Correspondence to Prof Hugh Markus, Dept of Clinical Neurosciences, St Georges Hospital Medical School, Cranmer Terrace, Tooting, London SW17 0RE, United Kingdom. E-mail hmarkus{at}sghms.ac.uk

Background and Purpose— Transcranial Doppler (TCD) ultrasound can detect asymptomatic emboli in carotid stenosis. Current systems are nonportable and can only record for short durations. A novel ambulatory TCD system allows prolonged recording. We applied this to patients with symptomatic and asymptomatic carotid stenosis to determine patterns of embolization in the 2 conditions and optimal recording protocols.

Methods— Ambulatory TCD recordings were performed in 12 symptomatic and 15 asymptomatic carotid stenosis (50%) patients for 8 hours and then repeated on a second occasion.

Results— Nine (75%) of symptomatic subjects had embolic signals during the first recording. In this group, repeating the recording did not increase the proportion of positive patients. In asymptomatic patients, 4 (26.7%) had embolic signals on 1 recording, and this proportion increased to 46.7% after 2 recordings. There was significant clustering of embolic signals demonstrating that the process was nonrandom.

Conclusions— Ambulatory TCD is possible in patients with carotid artery stenosis. By increasing the duration of recording, additional information is provided, particularly in asymptomatic patients. Our results also demonstrate clustering of embolic signals. Our study provides baseline data to allow studies in both asymptomatic and symptomatic carotid stenosis to be planned.

Key Words: carotid stenosis • stroke • ultrasonography, Doppler, transcranial

This article has been cited by other articles:

				H. Poppert, S. Sadikovic, K. Sander, O. Wolf, and D. Sander Embolic Signals in Unselected Stroke Patients: Prevalence and Diagnostic Benefit Stroke, August 1, 2006; 37(8): 2039 - 2043. [Abstract] [Full Text] [PDF]