Microembolic Signals Detected by Transcranial Doppler Predict Future Stroke and Poor Outcomes. Issue 6 (10th July 2020)

• Record Type: Journal Article
• Authors: Das, Alvin S.; Regenhardt, Robert W.; LaRose, Sarah; Monk, Andrew D.; Castro, Pedro M.; Sheriff, Faheem G.; Sorond, Farzaneh A.; Vaitkevicius, Henrikas
• Is Part Of: Journal of neuroimaging. Volume 30:Issue 6(2020)
• Page Start: 882
• Page End: 889
• Publication Date: 2020-07-10
• Subjects: Neurosonology -- transcranial Doppler sonography -- cerebral emboli -- stroke -- recurrence; Diagnostic imaging -- Periodicals; Nervous system -- Diseases -- Diagnosis -- Periodicals; Imagerie pour le diagnostic -- Périodiques; Système nerveux -- Maladies -- Diagnostic -- Périodiques; Imagerie médicale; Neuroimagerie; Neurologie; Système nerveux; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.804754
• DOI: 10.1111/jon.12749
• Languages: English
• ISSNs: 1051-2284

Abstract

ABSTRACT: BACKGROUND AND PURPOSE: Although transcranial Doppler detects microembolic signals (MES) in numerous settings, the practical significance of such findings remains unclear. METHODS: Clinical information from ischemic stroke or transient ischemic attack patients ( n = 248) who underwent embolic monitoring from January 2015 to December 2018 was obtained. RESULTS: MES were found in 15% of studies and ischemic recurrence was seen in 11% of patients (over 7 ± 6 days). Patients with MES had more lacunes than those without MES (1 ± 3 vs. 1 ± 2, P = .016), were more likely to have ischemic recurrence (37% vs. 6%, P < .001), undergo a future revascularization procedure (26% vs. 10%, P = .005), have a longer length of stay (9 vs. 4 days, P = .043), and have worse functional disability at discharge (modified Rankin Scale 3‐6, 66% vs. 34%, P < .001). After controlling for several relevant cofactors, patients with MES were more likely to have ischemic recurrence (HR 4.90, 95% CI 2.16‐11.09, P < .001), worse functional disability (OR 3.31, 95% CI 1.22‐8.99, P = .019), and longer length of stays (β = .202, P < .001). CONCLUSIONS: MES may help to risk stratify patients as their presence is associated with ischemic recurrence and worse outcomes.