engleski

Analysis of cerebral microemboli in relationship to carotid stenosis and plaque type

The objective of this study was to assess the prevalence and acoustic properties of cerebral emboli using TCD in patients with extracranial carotid artery stenosis in relationship to carotid stenosis and plaque type. Risk factors for stroke were also correlated with plaque type. A total of 39 patients with extracranial carotid artery stenosis was examined by color coded duplex sonography. The patients were divided into 3 groups according to carotid stenosis degree:mild, moderate and severe ; and according to plaque type also into 3 groups: soft, calcified and fibrous. Simultaneous TCD monitoring of both a.cerebri media was performed over 60 minutes. Detected emboli signals were categorised into 3 groups according to the intensity of the Doppler amplitude (9-11, 12-17, and over 18 dB). Cholesterol, triglicerides, blood glucose and hypertension were also evaluated. Emboli signals were detected in 15 patients (38.5 percent). In patients with mild stenosis no emboli were detected. In patients with moderate stenosis with soft plaque, 4 from 9 (44.4 percent) were emboli positive, as well as 5 from 18 (27.7 percent) patients with fibrous plaque. In patients with a severe stenosis, all patients with soft plaques (4) had detectable emboli signals, and 6 out of 13 (46.2 percent) with fibrous plaques. Most of the detected emboli signals were placed in lower intensity groups of the Doppler amplitude. Patients with soft plaques had higher findings of blood glucose, lipids and hypertension, but not statistically significant.Cerebral emboli signals can be detected in a large proportion of patients with extracranial carotid artery disease. The prevalence of detected emboli was higher in patients with severe carotid stenosis, and in those with predominantly soft plaques. The detection of cerebral emboli by TCD may help to identify high risk stroke patients and allow the evaluation of preventive stroke therapies.

transcranial Doppler; cerebral microemboli

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