Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany.
Cerebrovasc Dis. 2011;32(2):163-9. doi: 10.1159/000328883. Epub 2011 Jul 22.
Carotid artery stenting (CAS) is associated with the risk of periprocedural embolic events. The procedural risk may vary with plaque characteristics. We aimed at determining the impact of carotid plaque surface irregularity on the risk of cerebral embolism during CAS.
Solid microembolic signals (MES) during CAS for symptomatic carotid stenosis were assessed by means of dual-frequency transcranial Doppler ultrasound. Study endpoint was the number of solid MES during CAS in 12 patients with irregular carotid stenosis compared to 12 matched patients with smooth carotid stenosis.
A total of 438 solid MES were detected. The cumulative number of solid MES was 329 in patients with irregular plaques and 109 in those with smooth plaques. The proportion of subjects in whom solid MES were detected was higher in the irregular plaque group (11/12) than in the smooth plaque group (5/12) (p = 0.030). The numbers of solid MES per CAS procedure and per hour of CAS procedure were both higher in patients with irregular plaques than in those with smooth plaques (p = 0.008 and 0.015, respectively).
Carotid plaque surface irregularity predicts solid cerebral embolism during stenting of symptomatic carotid artery stenosis.
颈动脉支架置入术（CAS）与围手术期栓塞事件的风险相关。手术风险可能因斑块特征而异。我们旨在确定颈动脉斑块表面不规则对症状性颈动脉狭窄患者 CAS 期间发生脑栓塞的风险的影响。
通过双频经颅多普勒超声评估症状性颈动脉狭窄患者的 CAS 期间的实性微栓子信号（MES）。研究终点是 12 例颈动脉狭窄不规则患者与 12 例颈动脉狭窄光滑患者在 CAS 期间的实性 MES 数量。
共检测到 438 个实性 MES。在不规则斑块患者中，实性 MES 的累计数量为 329，在光滑斑块患者中为 109。在不规则斑块组中，检测到实性 MES 的患者比例（11/12）高于光滑斑块组（5/12）（p = 0.030）。在不规则斑块患者中，每例 CAS 手术和每小时 CAS 手术的实性 MES 数量均高于光滑斑块患者（p = 0.008 和 0.015）。
颈动脉斑块表面不规则预测症状性颈动脉狭窄患者 CAS 期间的实性脑栓塞。
