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Relationship between microemboli in the internal carotid artery and the occurrence of ischemic stroke after transient

Wei-Song Liu1, Shao-Fen Zhu, Wei-Feng Liu

  • 1Department of Internal Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|July 23, 2013
PubMed

Insights

Microembolic signals (MES) detected in the internal carotid artery are a significant predictor of stroke after a transient ischemic attack (TIA). Patients with MES experienced more strokes and TIAs, highlighting MES as a key risk factor.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Microembolic signals (MES) are recognized as an independent risk factor for stroke and transient ischemic attack (TIA).
  • Understanding the predictive value of MES in the internal carotid artery is crucial for stroke risk assessment in TIA patients.

Purpose of the Study:

  • To investigate the association between MES in the internal carotid artery and the incidence of ischemic stroke in patients who have experienced a TIA.
  • To determine the predictive value of MES for subsequent ischemic stroke events.

Main Methods:

  • Sixty-seven TIA patients underwent transcranial Doppler ultrasonography to detect MES in the internal carotid artery at multiple time points.
  • Follow-up assessments were conducted 1, 3, and 7 days post-admission and 3 months post-discharge.
  • The primary outcome was the occurrence of ischemic stroke, with MES status as the key predictor.

Main Results:

  • 35.8% of patients were positive for MES (MES(+)).
  • Ischemic stroke occurred significantly more frequently in MES(+) patients (25.0%) compared to MES(-) patients (4.7%) (p=0.021).
  • MES(+) status remained a significant independent predictor of ischemic stroke (OR: 8.30; 95% CI: 1.37-50.42; p=0.021) after adjusting for covariates.

Conclusions:

  • The presence of microemboli in the internal carotid artery is a significant risk factor for ischemic stroke following TIA.
  • MES detection offers valuable prognostic information for stroke risk stratification in TIA patients.
  • Higher MES rates were observed in TIA patients with severe internal carotid artery stenosis.
Keywords:
Internal carotid arteryIschemic strokeMicroemboliMicroembolic signalsTranscranial Doppler ultrasonographyTransient ischemic attack

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