Abstract 2386: Microembolic Signals in Acute Posterior Circulation Cerebral Ischemia: Sources and Consequences
Background: The clinical significance of microembolic signals (MESs) in posterior circulation remains unclear. The aim of this study was to investigate the sources and consequences of MESs in acute posterior circulation cerebral ischemia.
Methods: We evaluated a total of 140 consecutive patients (93 males, mean age 62.9 years) who had acute posterior circulation cerebral ischemia. The MES monitoring was conducted at the basilar artery through the suboccipital window during 30 minutes.
Results: Microembolic signals were detected in 18 (12.9%) of the 140 patients. Clinical characteristics and laboratory data did not differ between the MES-positive and MES-negative groups. Intracranial vertebrobasilar artery (VBA) stenosis was independently associated with the presence of MES (OR: 9.37, 95% CI: 1.14-79.92, p =0.037), while the patients whose vertebral artery stenosis was limited at the extracranial portion did not show a significant difference. Microembolic signals occurred significantly more frequently in patients with a severe degree of VBA stenosis compared to those with non-significant stenosis (OR: 9.81, 95% CI: 1.21-79.87; p =0.033). In a subgroup analysis of the 79 patients who had lesions on diffusion-weighted images and relevant VBA stenosis, the MES-positive group showed more frequent embolic infarction (p=0.010) and multiple lesion patterns (p=0.007) than they did single perforating infarctions.
Conclusions: In acute posterior circulation cerebral ischemia, intracranial and severe VBA stenosis is associated with MES and could be its root cause; the presence of MES in VBA stenosis may suggest multiple and embolic type infarctions as the stroke mechanism
- © 2012 by American Heart Association, Inc.