The purpose of the present study was to determine whether cerebral hyperperfusion after revascularization inhibits development of cerebral ischemic lesions due to artery-to-artery emboli during exposure of the carotid arteries in carotid endarterectomy (CEA). In patients undergoing CEA for internal carotid artery stenosis (≥70%), cerebral blood flow (CBF) was measured using single-photon emissi...

BACKGROUND AND PURPOSE High numbers of microembolic signals (MES) have been associated with increased risk of postoperative stroke after carotid endarterectomy (CEA). We sought to identify factors predictive of postoperative MES. METHODS Transcranial Doppler monitoring of the ipsilateral middle cerebral artery for MES was performed for 30 minutes during the first postoperative hour in sequent...

BACKGROUND Chronic microembolization that can be demonstrated by pulsed Doppler ultrasound may give rise to pulmonary side-effects during haemodialysis by direct vessel obstruction, increased complement activation or platelet aggregation. The objective of the present investigation was to study whether the use of pre-filled instead of dry dialysers would help to minimize the number of microembol...

BACKGROUND Microembolic signals (MES) as detected by transcranial Doppler ultrasound define an individual stroke risk in patients with carotid artery disease. To study the composition of MES in vivo, we used the glycoprotein IIb/IIIa (GPIIb/IIIa) receptor antagonist tirofiban, a highly selective platelet aggregation inhibitor. METHODS AND RESULTS Twenty-four patients with recent cerebral or r...

Paradoxical embolization is the most commonly proposed mechanism for ischemia in patients with patent foramen ovale (PFO). We hypothesize that these patients can experience a microembolic genesis of cochleovestibular dysfunction, with a peripheral vestibular syndrome and simultaneous cochlear signs. Hence, we report the first case in literature associating PFO and acute transitory audiovestibul...

BACKGROUND AND PURPOSE Cerebral embolism is a common cause of stroke. Microembolic signals (MES) detected by transcranial Doppler represent ongoing embolisms, but the lack of reliable data about its clinical relevance hinders its widespread use in clinical practice. METHODS We prospectively monitored 114 consecutive acute ischemic stroke patients with middle cerebral artery (MCA) stenosis for...

BACKGROUND The prevalence of microembolic signals (MES) during the acute phase of ischemic stroke and its influence on outcome is not well studied. The aim of our study was to determine the prevalence of MES, the different factors that are associated with the presence of MES and the association between MES and outcomes in stroke patients investigated within 6 hours after the onset of ischemic s...

The aim of the present study was to determine whether preoperative three-dimensional (3D) fast spin-echo (FSE) T1-weighted magnetic resonance (MR) plaque imaging for severely stenotic cervical carotid arteries could accurately predict the development of artery-to-artery emboli during exposure of the carotid arteries in carotid endarterectomy (CEA). Seventy-five patients underwent preoperative M...

Moyamoya disease (MMD) is an uncommon cerebrovascular disease that is characterized by progressive stenosis of the terminal portion of the internal carotid artery and its main branches. There have been many studies on the cerebral hemodynamics in patients with MMD, and based on their findings, current guidelines recommend revascularization surgery in patients with MMD with progressive ischemic ...

PURPOSE To evaluate a technique for contrast agent preparation as mixing the patients' blood with agitated saline and to compare it with agitated saline alone in diagnosis of cardiac right-to-left shunt in regard to their sensitivity, time window, and distribution of artificially induced microembolic signals. METHODS Fifty-two patients with stroke who had Transesophageal echocardiography prov...