Carotid sonography and transesophageal echocardiography in patients with ischemic stroke or transient ischemic attack in the territory of the carotid artery.
OBJECTIVE
To assess the benefit of combining carotid sonography and transesophageal echocardiography (TEE) for the evaluation of patients with stroke or transient ischemic attack (TIA) in the territory of the carotid artery.


METHODS
During a 2-year period in Turku University Hospital, consecutive in patients with stroke or TIA who were candidates for carotid endarterectomy and for oral anticoagulation were evaluated with carotid sonography for symptomatic moderate (50-69%) or severe (>or=70%) internal carotid artery (ICA) stenosis, and with TEE for potential cardiac sources of embolism.


RESULTS
In 20% (40/197) of patients, a severe symptomatic ICA stenosis and/or a major risk factor for a cardiac source of embolism were found. In 56% (110/197) of patients, a moderate or severe symptomatic ICA stenosis and/or a potential cardiac source of embolism were found, whereas 11% (21/197) of patients had both a moderate or severe symptomatic ICA stenosis and a potential cardiac source of embolism.


CONCLUSIONS
This study suggests that the presence of a moderate or severe symptomatic ICA stenosis does not exclude the presence of a potential cardiac source of embolism and vice versa. Carotid sonography and TEE complement each other and are valuable diagnostic tools that should be recommended in patients with ischemic stroke or TIA in the territory of the carotid artery when they are candidates for carotid endarterectomy and for oral anticoagulation.
Strandberg
Marjatta
M
Department of Clinical Physiology, Nuclear Medicine, and PET, Turku University Hospital, Kiinanmyllynkatu 4-8, 20520 Turku, Finland.
Marttila
Reijo J
RJ
Haapanen
Arto
A
Helenius
Hans
H
Hartiala
Jaakko
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D003328:Coronary Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018608:Ultrasonography, Doppler