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Microembolic Signals Predict Recurrence of Ischemic Events in Symptomatic Patients with Middle Cerebral Artery

Xiaomin Chen1, Kangding Liu1, Xiujuan Wu1

  • 1Neuroscience Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, China.

Ultrasound in Medicine & Biology
|February 4, 2018
PubMed

Insights

Microembolic signals (MESs) predict ischemic stroke recurrence in symptomatic middle cerebral artery (MCA) stenosis patients. However, MESs did not predict outcomes in asymptomatic MCA stenosis patients.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Middle cerebral artery (MCA) stenosis is a primary cause of ischemic stroke, particularly in Asian populations.
  • Predicting ischemic events in patients with MCA stenosis is crucial for effective management.
  • Microembolic signals (MESs) are potential indicators of embolic events.

Purpose of the Study:

  • To investigate the predictive value of microembolic signals (MESs) for ischemic stroke occurrence or recurrence in patients with MCA stenosis.
  • To compare the incidence of MESs and subsequent ischemic events between symptomatic and asymptomatic MCA stenosis groups.

Main Methods:

  • Transcranial Doppler ultrasound was used to detect microembolic signals (MESs) in patients with MCA stenosis.
  • Patients were categorized into symptomatic and asymptomatic groups based on clinical presentation.
  • Follow-up assessments were conducted to record the occurrence of cerebral infarction and transient ischemic attack (TIA).

Main Results:

  • Symptomatic MCA stenosis patients exhibited a significantly higher incidence of MESs (30% vs. 16.2%) compared to asymptomatic patients.
  • Symptomatic patients also showed higher rates of cerebral infarction and TIA.
  • In symptomatic MES-positive patients, the incidence of TIA was significantly higher (36.7% vs. 14.3%) during follow-up.
  • No significant differences in outcomes were observed between MES-positive and MES-negative asymptomatic patients.

Conclusions:

  • Microembolic signals (MESs) are valuable predictors of ischemic events, particularly TIA recurrence, in symptomatic patients with MCA stenosis.
  • MES detection may not be a significant prognostic indicator in asymptomatic MCA stenosis patients.
  • Further research is warranted to clarify the role of MESs in asymptomatic MCA stenosis management.
Keywords:
EmbolismIntracranial artery stenosisMicroembolic signalsStrokeTranscranial Doppler sonographyTransient ischemic event

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