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Carotid sonography and transesophageal echocardiography in patients with ischemic stroke or transient ischemic attack in the territory of the carotid artery
Author(s) -
Strandberg Marjatta,
Marttila Reijo J.,
Haapanen Arto,
Helenius Hans,
Hartiala Jaakko
Publication year - 2006
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.20255
Subject(s) - medicine , carotid endarterectomy , stenosis , embolism , stroke (engine) , cardiology , internal carotid artery , radiology , atrial fibrillation , endarterectomy , mechanical engineering , engineering
Purpose. To assess the benefit of combining carotid sonography and transesophageal echocardiography (TEE) for the evaluation of patients with stroke or transient ischemic attack (TIA) in the territory of the carotid artery. Methods. During a 2‐year period in Turku University Hospital, consecutive in patients with stroke or TIA who were candidates for carotid endarterectomy and for oral anticoagulation were evaluated with carotid sonography for symptomatic moderate (50–69%) or severe (≥70%) internal carotid artery (ICA) stenosis, and with TEE for potential cardiac sources of embolism. Results. In 20% (40/197) of patients, a severe symptomatic ICA stenosis and/or a major risk factor for a cardiac source of embolism were found. In 56% (110/197) of patients, a moderate or severe symptomatic ICA stenosis and/or a potential cardiac source of embolism were found, whereas 11% (21/197) of patients had both a moderate or severe symptomatic ICA stenosis and a potential cardiac source of embolism. Conclusions. This study suggests that the presence of a moderate or severe symptomatic ICA stenosis does not exclude the presence of a potential cardiac source of embolism and vice versa. Carotid sonography and TEE complement each other and are valuable diagnostic tools that should be recommended in patients with ischemic stroke or TIA in the territory of the carotid artery when they are candidates for carotid endarterectomy and for oral anticoagulation. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 34:374–379, 2006