Volume 49, Issue 2 June 2025 JVU 492-93| Clinical Risk Factors for Stroke and Associations with Micro Embolic Signals on Transcranial Doppler-Volume 49, Issue 2 June 2025 JVU 492-93| Clinical Risk Factors for Stroke and Associations with Micro Embolic Signals on Transcranial Doppler

Volume 49, Issue 2 June 2025 JVU 492-93| Clinical Risk Factors for Stroke and Associations with Micro Embolic Signals on Transcranial Doppler

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The study published in the Journal for Vascular Ultrasound explores the association between clinical risk factors and microembolic signals (MES) detected via transcranial Doppler (TCD) in patients with advanced carotid atherosclerosis (CAS). The research highlights that strokes, largely ischemic in nature, are a significant health burden in the U.S., leading to considerable healthcare costs and cognitive decline related to both obvious and silent strokes.<br /><br />Conducted at the University of Wisconsin, the study involved 89 participants with severe CAS (minimum of 60% stenosis), evaluated preoperatively for MES using TCD. The objective was to investigate the relationship between MES and demographic/clinical characteristics, helping identify patients at elevated risk for future strokes and cognitive impairment.<br /><br />Key findings indicate that MES are significantly associated with older age and male sex, with 36% of the participants showing MES. No significant correlation was found between MES presence and other risk factors such as blood pressure, diabetes, and symptomatic status. The study suggests that both symptomatic and asymptomatic patients with CAS can release microemboli, potentially increasing the risk of cognitive decline. It is proposed that MES could originate from unstable carotid plaques, placing individuals at further risk of cerebral ischemia.<br /><br />The results underline the necessity for further exploration into identifying unstable plaques that contribute to MES and, subsequently, stroke risk, especially given that MES can occur despite antiplatelet therapy, suggesting non-thrombotic causes like cholesterol crystals or plaque debris. The findings also emphasize the systemic nature of atherosclerosis and its role in plaque instability across the vascular system.<br /><br />While the study advances understanding, limitations include its small sample size and retrospective nature, signaling a need for more extensive future research to improve patient risk stratification and management strategies in CAS.

Keywords

vascular ultrasound

microembolic signals

transcranial Doppler

carotid atherosclerosis

ischemic strokes

cognitive decline

unstable plaques

cerebral ischemia

atherosclerosis

risk stratification