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Microembolic Signals Detected by Transcranial Doppler Predict Future Stroke and Poor Outcomes
Author(s) -
Das Alvin S.,
Regenhardt Robert W.,
LaRose Sarah,
Monk Andrew D.,
Castro Pedro M.,
Sheriff Faheem G.,
Sorond Farzaneh A.,
Vaitkevicius Henrikas
Publication year - 2020
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12749
Subject(s) - medicine , transcranial doppler , modified rankin scale , cardiology , ischemic stroke , revascularization , stroke (engine) , ischemia , mechanical engineering , myocardial infarction , engineering
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.