M.A.R. and K.T. contributed equally to the manuscript.
Vascularization of carotid plaque in recently symptomatic patients is associated with the occurrence of transcranial microembolic signals
Article first published online: 20 NOV 2012
© 2012 The Author(s) European Journal of Neurology © 2012 EFNS
European Journal of Neurology
Volume 20, Issue 8, pages 1218–1221, August 2013
How to Cite
Ritter, M. A., Theismann, K., Schmiedel, M., Ringelstein, E. B. and Dittrich, R. (2013), Vascularization of carotid plaque in recently symptomatic patients is associated with the occurrence of transcranial microembolic signals. European Journal of Neurology, 20: 1218–1221. doi: 10.1111/ene.12030
- Issue published online: 5 JUL 2013
- Article first published online: 20 NOV 2012
- Manuscript Accepted: 8 OCT 2012
- Manuscript Received: 27 JUN 2012
- ‘Innovative Medical Research
- University of Münster Medical School. Grant Number: I-DI210901
- carotid artery;
- microembolic signals;
Background and purpose
Microembolic signals (MES) are detectable in the middle cerebral artery by transcranial ultrasound downstream to atherosclerotic lesions of the internal carotid artery (ICA) in patients with stroke or transient ischaemic attack. The occurrence of MES predicts future risk of stroke in patients with symptomatic and asymptomatic carotid stenosis. The detection of intra-plaque neo-vascularization by contrast-enhanced ultrasound (CEUS) in atherosclerotic plaques of the ICA is associated with future cardiovascular/cerebrovascular events. We investigated whether there is an association between both surrogate markers of future vascular events.
Forty-one patients with symptomatic atherosclerotic plaques underwent ipsilateral transcranial ultrasound MES detection for 30 min followed by a CEUS investigation of the plaque. The occurrence and number of MES was documented, and the degree of intra-plaque neo-vascularization was measured semi-quantitatively.
During the 30 min investigation, 17 patients had MES and nine of them showed neo-vascularization of the atherosclerotic plaque. The remaining 24 patients did not have MES, and only in four patients of this group could plaque neo-vascularization be demonstrated (P = 0.020).
We found an association between the occurrence of MES and the presence of neo-vascularization in patients with symptomatic atherosclerotic carotid plaque. Therefore, plaque neo-vascularization might also be a surrogate marker of future stroke risk.