Document Detail


Spontaneous Cerebral Embolisation in Asymptomatic and Recently Symptomatic Patients with TIA/Minor Stroke.
MedLine Citation:
PMID:  21333556     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: Spontaneous embolisation (SE) detected using Transcranial Doppler (TCD) after a Transient Ischaemic Attack (TIA)/Minor stroke is an independent predictor of recurrent stroke. There are, however limited data on the differential prevalence of SE in the first few days/weeks after onset of symptoms. METHOD: 156 consecutive patients (symptomatic n = 123, asymptomatic n = 33) underwent Carotid Endarterectomy (CEA) during an 18 month period and had an accessible window permitting 30 min of pre-operative TCD monitoring. A prospective study was conducted with assessors blinded to clinical status. RESULTS: Spontaneous embolisation was detected in 31 symptomatic patients (25%) of which 1/1 (100%), 14/35 (40%), 8/37 (22%) and in 8/50 (16%) patients presented within 48 h, 3-7 days, 8-14 days and >14 days respectively from the index clinical event. SE occurred in only 6% of asymptomatic patients. Out of 31 symptomatic patients with SE, seven (22.6%) suffered recurrent cerebrovascular events following admission as opposed to 11/92 patients (11.9%) who had no evidence of spontaneous embolisation after admission (OR 2.2 (95% CI 0.8-6.1))(P = 0.2) CONCLUSION: Patients presenting for CEA in the hyperacute period after onset of TIA/Minor stroke have a high incidence of SE. Patients with SE had a 23% risk of recurrent cerebrovascular events. These data support the current drive towards expedited CEA in recently symptomatic patients.
Authors:
M K Salem; H Z Butt; A P W Watts; R D Sayers; M J Bown; A R Naylor
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-16
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  -     ISSN:  1532-2165     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Vascular Surgery Group, Department of Cardiovascular Sciences, Robert Kilpatrick Clinical Sciences Building, University of Leicester, LE2 7LX, United Kingdom.
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