Abstract WP266: Microembolic Signals and Association With Stroke Etiology in Ischemic Stroke

Abstract

Background: Microembolic signals (MES) detected by the transcranial Doppler ultrasound (TCD) have established prognostic value for stroke recurrence in patients with carotid stenosis. However, the frequency of MES in the context of other stroke etiologies remains unknown. Methods: All stroke admissions to Northwestern Memorial hospital between 2016-2018 who underwent TCD within the first 48 hours of admission were reviewed. Final stroke diagnosis was extracted from chart review. Presence or absence of MES was extracted from clinical TCD reports. Frequency of stroke etiology among MES groups were compared using chi-squared test. Results: A total of 789 patient charts were reviewed (mean age 62±17 years, 55% male). MES were present in 95 patients. Demographics and medical history of patients were not different among those with and without MES. Compared to patients without MES, those with MES were more frequently diagnosed with cardioembolic stroke (36.4% vs 21%, p =0.001) and less frequently with small vessel disease stroke (5.7% vs 24%, p <0.001). However, there was no difference in the frequency of cryptogenic strokes between patients with and without MES ( p =0.844). Among patients with MES, the most frequent etiologies of stroke were cardioembolic (36.4%), cryptogenic (19.3%), large vessel disease (17.1%), and small vessel disease (5.7%). Conclusion: TCD detection of MES is seen across all stroke subtypes and may provide additional information for risk stratification in secondary stroke prevention. We are currently reviewing the prognostic utility of MES for stroke recurrence in this cohort.