• Vasc Endovascular Surg · Oct 2010

    Carotid stenting and transcranial Doppler monitoring: indications for carotid stenosis treatment.

    • Roberto Gattuso, Ombretta Martinelli, Alessia Alunno, Ilaria D'Angeli, Marco Felli, Anna Castiglione, Luciano Izzo, and Bruno Gossetti.
    • Department of Vascular Surgery A, Sapienza University, Rome, Italy.
    • Vasc Endovascular Surg. 2010 Oct 1; 44 (7): 535-8.

    BackgroundRecently, 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.MethodsA total of 152 patients were submitted to carotid stenting. All patients were submitted to carotid arteries Duplex scanning.ResultsNeurological 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.ConclusionsAccording 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).

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