OBJECTIVE: To investigate the association between carotid plaque characteristics and the occurrence of cerebral microemboli signals (MES) and subsequent ischemic events in patients with asymptomatic carotid stenosis (ACS). DESIGN: Sixty-two asymptomatic patients with 50-99% carotid stenosis underwent transcranial Doppler (TCD) monitoring to determine the relationship between MES and plaque characteristics. The patients were followed for 1 year, and the incidence of transient ischemic attack (TIA)/stroke was studied. RESULTS: MES were found in 10/62 of the patients at baseline, and there was a significant difference between the patients with moderate stenosis and those with severe stenosis on the presence of MES (p = 0.016). Furthermore, MES were more frequently found in patients with irregular and/or heterogeneous plaques than in those with regular (p = 0.028) and/or homogeneous plaques (p = 0.021). The incidence of TIA/stroke occurred more frequently in patients with MES than those without MES (p = 0.009). The proportion of progressive carotid stenosis was 4/50 in the patients with 50-99% stenosis during 1 year follow-up. CONCLUSION: Asymptomatic patients (with 50-99% carotid stenosis) with MES presented a significantly increased frequency of severe stenosis, with irregular and heterogeneous plaques.
OBJECTIVE: To investigate the association between carotid plaque characteristics and the occurrence of cerebral microemboli signals (MES) and subsequent ischemic events in patients with asymptomatic carotid stenosis (ACS). DESIGN: Sixty-two asymptomatic patients with 50-99% carotid stenosis underwent transcranial Doppler (TCD) monitoring to determine the relationship between MES and plaque characteristics. The patients were followed for 1 year, and the incidence of transient ischemic attack (TIA)/stroke was studied. RESULTS:MES were found in 10/62 of the patients at baseline, and there was a significant difference between the patients with moderate stenosis and those with severe stenosis on the presence of MES (p = 0.016). Furthermore, MES were more frequently found in patients with irregular and/or heterogeneous plaques than in those with regular (p = 0.028) and/or homogeneous plaques (p = 0.021). The incidence of TIA/stroke occurred more frequently in patients with MES than those without MES (p = 0.009). The proportion of progressive carotid stenosis was 4/50 in the patients with 50-99% stenosis during 1 year follow-up. CONCLUSION: Asymptomatic patients (with 50-99% carotid stenosis) with MES presented a significantly increased frequency of severe stenosis, with irregular and heterogeneous plaques.