Background And Purpose: The detection of microembolic signals in transcranial-Doppler monitoring is associated with a higher stroke risk. We investigated the correlation between the frequency of microembolic signals and the efficacy of the antiplatelet therapy in patients with a recent symptomatic carotid-artery stenosis.
Subjects And Methods: Thirty-two patients (mean age: 70 years, 22 men) with a recent symptomatic carotid-artery stenosis underwent 30-minute TCD-monitoring. Twenty-three patients received acetylsalicylic-acid and 9 patients clopidogrel as antiplatelet-therapy. At the same day, the antiplatelet effect was measured with multiple-electrode-impedance aggregometry.
Results: In 20 cases, the qualifying event was a stroke and in 12 cases, a TIA. Twenty-six of the patients had a >50% degree of stenosis. More than one microembolic signals were detected in 13 (40.6%) of the subjects, while multiple-electrode-impedance aggregometry revealed eight low responders (6 acetylsalicylic-acid, 2 clopidogrel). More than one microembolic signals were detected in 6 of the 8 (75.0%) patients with low response, but in only 7 of the 24 subjects (29.2%) with an effective antiplatelet treatment (sensitivity 75%, specificity 70.8%; Fisher's exact test: P = .038).
Conclusions: Our study suggests that in patients with recent symptomatic carotid-artery stenosis the detection of more than one microembolic signals might serve as a useful marker for the effectiveness of the antiplatelet treatment.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1552-6569.2012.00770.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Microembolic signal detection in acute ischemic stroke: Clinical relevance and impact on treatment individualization-A narrative review.
Eur J Neurol
January 2025
Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Background: Microembolic signals (MES) can be detected using transcranial Doppler (TCD) ultrasound in several clinical scenarios, including acute ischemic stroke (AIS). This narrative review aims to provide insights into their role in AIS patient management and outcomes.
Methods: The present narrative review consolidates current observational and randomized evidence on the prevalence and clinical relevance of MES in different AIS subtypes and settings.
Incidence of Microembolic Signals on Transcranial Doppler among Patients with Symptomatic Carotid Near Occlusion.
Eur J Vasc Endovasc Surg
November 2024
Institution of Clinical Sciences, Department of Neurosciences, Umeå University, Umeå, Sweden; Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden; Wallenberg Centre of Molecular Medicine, Umeå University, Umeå, Sweden.
Article Synopsis
- The study investigates the causes of ischaemic stroke in patients with symptomatic carotid near occlusion, focusing on whether an embolic or haemodynamic mechanism is responsible.
- Researchers compared the occurrence of microembolic signals (MES) in patients with symptomatic near occlusion, symptomatic conventional ≥ 50% stenosis, and asymptomatic ≥ 50% stenosis to determine the differences.
- Findings revealed that MES incidence was significantly higher in symptomatic near occlusion patients compared to both symptomatic conventional stenosis and asymptomatic cases, suggesting a potential link to increased embolic activity.
The immunopathology of coronary microembolization and the underlying inflammopathophysiological mechanisms.
Allergol Immunopathol (Madr)
November 2024
Department of ICU, Wuhan Wuchang Hospital, Wuhan, China;
In coronary microembolization, inflammatory cell infiltration, patchy necrosis, and extensive intra-myocardial hemorrhage are dominant, which induce myocardial dysfunction with clinical symptoms of chronic ischemic cardiomyopathy. Microembolization can lead to obstruction of the coronary microvessels and result in the micro-infarction of the heart. The inflammation and elevated expression of the tumor necrosis factor in cardiomyocytes and the activation of extracellular ERK are involved in initiating the inflammatory response mechanism.
View Article and Find Full Text PDFBezafibrate mitigates cardiac injury against coronary microembolization by preventing activation of p38 MAPK/NF-κB signaling.
Aging (Albany NY)
October 2024
Department of Cardiology, Chongyi People’s Hospital, Ganzhou 341399, Jiangxi Province, China.
Article Synopsis
- The study looked at how a drug called Bezafibrate can help protect the heart from damage caused by coronary microembolization (CME), which is when small blood clots block tiny heart blood vessels.
- Researchers tested Bezafibrate on rats with heart damage and found that it improved heart function, reduced markers of injury, and lowered inflammation.
- Bezafibrate was also shown to prevent heart cell death and act through certain biological pathways, suggesting it could be a helpful treatment for heart problems related to CME.
Unusual Evidence of Fat Embolism in the Subclavian Vein Detected by High-Intensity Transient Signals.
Methodist Debakey Cardiovasc J
September 2024
Houston Methodist, Houston, Texas, US.
Fat emboli may occur in patients after traumatic fractures or orthopedic procedures; however, their clinical detection is a very rare finding. Here, we describe a 77-year-old female who was admitted to the emergency department with a fracture of the right humerus. We diagnosed fat embolism after an ultrasound of the right subclavian vein.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!