Asymptomatic microembolic signals at the patients with carotid atherosclerosis as the predictors of acute ischemic cerebrovascular complications

Despite the subclinical character, asymptomatic carotid stenosis accounts for a substantial cerebral stroke burden. Transracial Doppler monitoring adjust to detect the signs of microembolisation from plaque surface - microembolic signals (MES). We aimed to evaluate MES as an independent marker of subsequent ischemic stroke and in combination with other anamnestic and clinical features. One hundred and sixty patients with 50% and more (by NASCET) carotid stenosis, assessed by ultrasound, with no sources of cardiogenic embolism were recruited. TCD recordings have been taken from the ipsilateral middle cerebral artery all the patients during an hour at baseline, in 10 days, 6 months and 12 months. Cerebral microembolism appear to be significant independent predictor of primary ischemic cerebral vascular events. MES in clinical asymptomatic patients in conjunction with the age older 60 years, contralateral carotid stenosis, ultrasound plaque characteristic and the absence of antithrombotic therapy are factors determine the repeat development artery-to-artery embolism from the carotid plaque. The multivariate analysis and discriminant inequality reveal the patients group with high risk of subsequent ischemic cerebral events. This technique might be a useful risk predictor for identifying those patients who might benefit from intervention with carotid endarterectomy.