Cerebral embolism and related vascular complications during carotid endarterectomy and carotid angioplasty with stenting

Abstract

Aim. Cerebral microembolic signals (MES) detected by transcranial Doppler are frequent during carotid angioplasty with stenting (CAS) and carotid endarterectomy (CEA). Their potential harmful effects on the brain are, however, unclear. The aim of this study was to relate the frequency and type of per-procedural microembolic signals to procedure-related ipsilateral ischemic strokes. Methods. Forty-one patients with internal carotid stenosis >70%, who were prospectively treated with CEA (26) or CAS (15) were monitored during the procedures using transcranial Doppler with embolus detection and differentiation. Results. CAS is associated with a significantly higher rate of cerebral embolization than CEA, but the number of solid MES dominated in CEA group. Solid MES were independently associated with procedure-related ipsilateral ischemic events.