title: [Detection of micro-embolic signals: a review of the literature].
abstract: BACKGROUND
  The detection of micro-embolic signals (MES), by transcranial Doppler sonography might be useful for risk stratification in patients with symptomatic and asymptomatic carotid or cerebral artery stenosis, dissections, aortic atheroma, interventional procedures, and right to left cardiac shunts.
  
  
  OBJECTIVE
  Review of the technique and clinical situations of MES detection.
  
  
  METHODS
  PubMed search from 1990 to 2012.
  
  
  RESULTS
  MES were found in 0,19, 48% versus 0,3, and 12% of patients with symptomatic and asymptomatic inferior than 30, 30 to 69, and 70 to 99% carotid stenosis, respectively. MES were related to the risk of recurrent stroke or transient ischemic attack (TIA). In the ACES study, the absolute annual risk of stroke or TIA after 2 years was 7% with vs 3% without MES. In patients with intracranial stenosis, the risk of stroke recurrence was 48% with vs 7% without MES at 13.6 months follow-up. MES were reported in 25% of the symptomatic versus none of the asymptomatic patients with intracranial stenosis.
  
  
  CONCLUSIONS
  Detection of MES is feasible and reproducible for multicenter studies, using rigourous methodology and long lasting recordings. It may contribute to risk stratification, especially in patients with extra- or intracranial stenosis.
authors.affiliation: Service de Médecine Vasculaire, Hôpital St-André, 1, rue Jean-Burguet, 33075 Bordeaux, France. carine.boulon@chu-bordeaux.fr
authors.forename: C
authors.initials: C
authors.lastname: Boulon
authors.forename: J-M
authors.initials: JM
authors.lastname: Baud
authors.forename: G
authors.initials: G
authors.lastname: Kercret
authors.forename: O
authors.initials: O
authors.lastname: Pichot
authors.forename: J-N
authors.initials: JN
authors.lastname: Poggi
authors.forename: J-C
authors.initials: JC
authors.lastname: Saby
authors.forename: M
authors.initials: M
authors.lastname: Sprynger
mesh_terms: D016893:Carotid Stenosis / Q000000981:diagnostic imaging; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging; D004617:Embolism / Q000000981:diagnostic imaging*; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000000981:diagnostic imaging; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging; D017585:Ultrasonography, Doppler, Transcranial