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April 1, 1994Neurology196 citations

Cerebral microembolism in symptomatic and asymptomatic high‐grade internal carotid artery stenosis

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MSM. SieblerAKAndreas KleinschmidtMSMatthias Sitzer

Key Result

Recent ischemic symptoms in patients with high-grade internal carotid artery stenosis were associated with a higher mean rate of silent microembolic events (14/h) versus asymptomatic patients (0.35/h).

Study Design

Type

Observational (n=89)

Structured PICO

Does the rate of TCD-detected silent microembolism differ between symptomatic and asymptomatic patients with high-grade internal carotid artery stenosis?

P
Population
89 patients with high-grade (>= 70%) internal carotid artery stenosis, including 33 with recent ischemic symptoms and 56 asymptomatic matched controls.
E
Exposure
Transcranial Doppler (TCD) ultrasonography monitoring
C
Comparator
Neurologically asymptomatic patients (for the comparison of symptomatic vs asymptomatic)
O
Outcome
Rate of TCD-detected silent microembolism of the ipsilateral middle cerebral arterysurrogate

TCD monitoring of silent microembolism can identify unstable internal carotid artery disease, strongly correlating with recent ischemic symptoms.

Main Result

Absolute Event Rate: 14% vs 0.35%

Abstract

Using transcranial Doppler (TCD) ultrasonography in patients with high-grade (> or = 70%) internal carotid artery (ICA) stenosis, we examined the relation between the rate of TCD-detected silent microembolism of the ipsilateral middle cerebral artery and a history of recent ( or = 2/h had a positive predictive value of 0.88 for a history of recent symptoms. Our data suggest that TCD monitoring can provide reliable paraclinical evidence of "unstable ICA disease."

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Cite This Study

Siebler et al. (1994) conducted an observational in High-grade internal carotid artery stenosis (n=89). Recent (< 121 days) ischemic symptoms vs. Neurologically asymptomatic was evaluated on Rate of TCD-detected silent microembolism of the ipsilateral middle cerebral artery. Recent ischemic symptoms in patients with high-grade internal carotid artery stenosis were associated with a higher mean rate of silent microembolic events (14/h) versus asymptomatic patients (0.35/h).

synapsesocial.com/papers/6a6acbe0f66cb1697bf402f1https://doi.org/10.1212/wnl.44.4.615
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