Plaque Length Predicts the Incidence of Microembolic Signals in Acute Anterior Circulation Stroke.

Liming Zhao,Yicheng Xu,Aijuan Zhang,Chenglin Tian,Hongqin Zhao,Jiatang Zhang,Xianwei Zeng

doi:10.1155/2021/2005369

Abstract

Microembolic signals (MES) of the carotid artery are associated with plaque destabilization and reoccurrence of stroke. Previous studies have focused primarily on the degree of carotid artery stenosis and plaque components, and the relationship between plaque length and microembolic sign has received little attention. We aimed to find the association between carotid plaque length (CPL) and the presence of MES. We conducted a retrospective observational cross-sectional study. A total of 84 acute anterior-circulation ischemic stroke/transient ischemic attack (TIA) patients with carotid artery atherosclerosis were classified into an MES-positive (MES+) group and MES-negative (MES−) group. We measured multiple parameters of carotid plaque size (length, thickness) in each patient and evaluated the relationship between different plaque parameters and occurrence of MES. We found that male, carotid artery stenosis (CAS), CPL, carotid plaque thickness (CPT), and intima-media thickness (IMT) of the carotid artery were each significantly different between two groups (all P < 0.05). The multivariate analysis showed CPL (odds ratio (OR), 1.109; 95% CI, 1.044–1.177; P = 0.001) to be independently associated with the presence of MES. The areas under the ROC curves (AUCs) for CPL for predicting MES were 0.777 (95% CI, 0.640–0.914; P < 0.001). The cutoff value of CPL for predicting MES was 16.7 mm, with a sensitivity of 88.2% and a specificity of 77.6%. We found that CPL was a meaningful independent predictor of MES. Therefore, CPL may be useful for risk stratification of long and nonstenotic plaques in anterior circulation stroke.

Highlights

Microembolic signals (MES) of the cerebral artery are associated with plaque destabilization and predict the occurrence of stroke [1,2,3,4,5]
We investigated the relationship between carotid plaque length (CPL) and MES lasting 60 min during Transcranial Doppler (TCD) monitoring within 72 h after the onset of acute stroke
There were no significant differences between MES+ and MES− patients in terms of age or the presence of hypertension, diabetes mellitus, ischemic heart disease, smoking, or drinking

Summary

Introduction

Microembolic signals (MES) of the cerebral artery are associated with plaque destabilization and predict the occurrence of stroke [1,2,3,4,5]. MES should be widely used in observational and interventional studies [7, 8]. A previous study [9] found that carotid plaque thickness ðCPTÞ > 3 mm may be a source of thromboembolic stroke. Another study shows CPT > 3 mm failed to be significantly different with ipsilateral embolic stroke of undetermined source [10]. Growth of plaque length of carotid artery is faster than their corresponding thicknesses [11]. Plaque length may be an underestimated indicator of carotid artery atherosclerosis. A few studies focus on the search of Disease Markers

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