A risk score to predict ischemic lesions after protected carotid artery stenting

Abstract 

Background

The morphological characteristics of atherosclerotic plaques are considered to determine their cerebral ‘embolic potential’. However, these are seldom considered during therapeutic decision-making.

Methods

Assessment and quantification of embolic potential by employing power-M-mode (PMD) transcranial Doppler (TCD) to strengthen risk scoring has been discussed.

Results

PMD-TCD is a reliable technique for monitoring of microembolic signals in intracranial arteries and can help in estimating the ‘embolic potential’ of carotid plaques. In addition to the diffusion-weighted imaging, assessment of neuro-cognitive functions may provide a better assessment of the safety of carotid interventions.

Conclusions

The proposed ‘risk scoring’ system can be further improved by incorporating the cerebral ‘embolic potential’ by PMD-TCD while cognitive assessments may be used for a more reliable evaluation of the safety of various carotid interventions.