Carotid stenting and transcranial Doppler monitoring: indications for carotid stenosis treatment.
BACKGROUND
Recently, angioplasty and stenting of carotid arteries (CAS) have taken the place of surgery. The aim of our study is to assess the role of transcranial Doppler (TCD) monitoring during CAS to address the embolic complications during the stages of the procedure, with or without embolic cerebral protection devices.


METHODS
A total of 152 patients were submitted to carotid stenting. All patients were submitted to carotid arteries Duplex scanning.


RESULTS
Neurological complications are related to TCD detection of corpuscolate signals in rapid succession. Even if no reduction of the overall incidence rate of microembolic signals (MES) was observed, a decrease in the number of corpuscolate emboli were recorded when a cerebral protection was working.


CONCLUSIONS
According to our study, even in selected patients on the basis of preoperative diagnostic criteria, CAS is burdened by a nonnegligible risk of subclinical embolic ischemic events detected at TCD and confirmed by diffusion-weighted magnetic resonance imaging (DW-MRI).
Gattuso
Roberto
R
Department of Vascular Surgery A, Sapienza University, Rome, Italy.
Martinelli
Ombretta
O
Alunno
Alessia
A
D'Angeli
Ilaria
I
Felli
Marco
M
Castiglione
Anna
A
Izzo
Luciano
L
Gossetti
Bruno
B
D000368:Aged; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation*; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D038524:Diffusion Magnetic Resonance Imaging; D057505:Embolic Protection Devices; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control; D007558:Italy; D011237:Predictive Value of Tests; D015607:Stents; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D017585:Ultrasonography, Doppler, Transcranial