Abstract Details

Title Transcranial Doppler-detected Microembolic Signals as a Predictor of New Brain Ischemic Lesion after Elective Coronary Intervention

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-060

Objective The aims were to investigate factors influencing the frequency and type of microembolic signals (MES) detected using Transcranial Doppler (TCD) in patients undergoing elective coronary intervention, and to correlate the frequency and type of MES with detection of new brain ischemic lesions using magnetic resonance imaging – diffusion-weighted images (MRI-DWI).

Background MES occur during endovascular coronary procedures. The association between total MES, stroke, and clinically silent brain infarctions is unclear.

Design/Methods In the prospective study, the set consisted of 70 patients (58 males; mean age 59.9±8.4years), who underwent bilateral TCD monitoring of middle cerebral arteries (MCA) during elective coronary interventions. Neurologic examination, and brain MRI-DWI were performed prior to and at 24 h after intervention. Cognitive function tests were performed prior to and 30 days after intervention.

Results Occurrence of diabetes mellitus was associated with a higher frequency of both total and solid MES counts contrary to atrial fibrillation which was associated with a significantly lower frequency of both total and solid MES counts (P?0.05 in all cases). The number of treated coronary arteries, the number of stents implanted, the volume of contrast agent and duration of the procedure were associated with a significantly higher frequency of both total and solid MES during the procedure in both MCA territories (P?0.05 in all cases). New ischemic lesions on control MRI-DWI were detected in 18 patients (25.7%). All lesions were clinically asymptomatic. The number and volume of new ischemic lesions did not correlate with the frequency and type of MES.

Conclusions The number and the type of MES do not predict development of new brain ischemic lesions after elective coronary interventions.

Authors/Disclosures
Roman Herzig, MD, PhD (Palacky University, Faculty of Medicine and Dentistry) PRESENTER	Roman Herzig, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca. Roman Herzig, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Boehringer Ingelheim . Roman Herzig, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Care Comm.
Dasa Viszlayova	No disclosure on file
David Skoloudik, MD, PhD (University Hospital Ostrava)	No disclosure on file
Miroslav Brozman, MD (Faculty Hospital Nitra)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Martin Valis, MD	Dr. Valis has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Valis has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. Valis has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva.

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