A risk score to predict ischemic lesions after protected carotid artery stenting
Received 3 September 2008; accepted 23 September 2008.
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.
Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074
ABSTRACT