Key result
The presence of cerebral microemboli signals in asymptomatic patients with 50-99% carotid stenosis was associated with a significantly higher incidence of TIA or stroke (p=0.009).
Why the study?
Does the presence of microembolic signals and specific carotid plaque characteristics predict ischemic events in patients with asymptomatic carotid stenosis?
Cohort (n=62)
Does the presence of microembolic signals and specific carotid plaque characteristics predict ischemic events in patients with asymptomatic carotid stenosis?
p-value: p=0.009
In asymptomatic patients with 50-99% carotid stenosis, the presence of microembolic signals is associated with irregular/heterogeneous plaques and a higher risk of subsequent TIA or stroke.
Should not yet guide revascularization in asymptomatic carotid stenosis; leaves open whether microemboli signals improve risk stratification in trials.
OBJECTIVE: To investigate the association between carotid plaque characteristics and the occurrence of cerebral microemboli signals (MES) and subsequent ischemic events in patients with asymptomatic carotid stenosis (ACS). DESIGN: Sixty-two asymptomatic patients with 50-99% carotid stenosis underwent transcranial Doppler (TCD) monitoring to determine the relationship between MES and plaque characteristics. The patients were followed for 1 year, and the incidence of transient ischemic attack (TIA)/stroke was studied. RESULTS: MES were found in 10/62 of the patients at baseline, and there was a significant difference between the patients with moderate stenosis and those with severe stenosis on the presence of MES (p = 0.016). Furthermore, MES were more frequently found in patients with irregular and/or heterogeneous plaques than in those with regular (p = 0.028) and/or homogeneous plaques (p = 0.021). The incidence of TIA/stroke occurred more frequently in patients with MES than those without MES (p = 0.009). The proportion of progressive carotid stenosis was 4/50 in the patients with 50-99% stenosis during 1 year follow-up. CONCLUSION: Asymptomatic patients (with 50-99% carotid stenosis) with MES presented a significantly increased frequency of severe stenosis, with irregular and heterogeneous plaques.
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Zhang et al. (2009) conducted a cohort in asymptomatic carotid stenosis (n=62). Cerebral microemboli signals (MES) vs. Absence of MES was evaluated on Incidence of transient ischemic attack (TIA)/stroke (p=0.009). The presence of cerebral microemboli signals in asymptomatic patients with 50-99% carotid stenosis was associated with a significantly higher incidence of TIA or stroke (p=0.009).
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