TY - JOUR
T1 - High intensity transient signals in patients with carotid stenosis may persist after carotid endarterectomy
AU - Kimura, Kazumi
AU - Stork, Jacinda L.
AU - Levi, Christopher R.
AU - Abbott, Anne L.
AU - Donnan, Geoffrey A.
AU - Chambers, Brian R.
PY - 2004/5/6
Y1 - 2004/5/6
N2 - Background: This study was undertaken to elucidate the natural history of high intensity transient signals (HITS) after carotid endarterectomy (CEA) and to determine whether this differs between patients with and without HITS detected preoperatively. Methods: A 30-min transcranial Doppler (TCD) recording was performed to detect HITS in 141 patients at 0-1 h, 2-3 h, 4-6 h and 24-36 h following CEA. 104 of these patients also had 30-min TCD monitoring within 48 h prior to CEA. Results: In the preoperative HITS-negative group, the proportion with postoperative HITS fell from 53% at 0-1 h to 17% at 24-36 h. In the preoperative HITS-positive group, the proportion with postoperative HITS remained steady (43% at 0-1 h, 52% at 24-36 h). During the 24-36 h postoperative epoch, 11 of 21 (52%) of the preoperative HITS-positive group had at least one HITS compared to 11 of 66 (17%) of the preoperative HITS-negative group (p = 0.001). In a multiple logistic regression analysis, preoperative HITS was the only factor associated with persistent postoperative HITS. Conclusion: The proportion of cases with postoperative HITS diminished in the 24-36 h after CEA except for preoperative HITS-positive patients. About half of our patients undergoing CEA with preoperative HITS might have another embolic source.
AB - Background: This study was undertaken to elucidate the natural history of high intensity transient signals (HITS) after carotid endarterectomy (CEA) and to determine whether this differs between patients with and without HITS detected preoperatively. Methods: A 30-min transcranial Doppler (TCD) recording was performed to detect HITS in 141 patients at 0-1 h, 2-3 h, 4-6 h and 24-36 h following CEA. 104 of these patients also had 30-min TCD monitoring within 48 h prior to CEA. Results: In the preoperative HITS-negative group, the proportion with postoperative HITS fell from 53% at 0-1 h to 17% at 24-36 h. In the preoperative HITS-positive group, the proportion with postoperative HITS remained steady (43% at 0-1 h, 52% at 24-36 h). During the 24-36 h postoperative epoch, 11 of 21 (52%) of the preoperative HITS-positive group had at least one HITS compared to 11 of 66 (17%) of the preoperative HITS-negative group (p = 0.001). In a multiple logistic regression analysis, preoperative HITS was the only factor associated with persistent postoperative HITS. Conclusion: The proportion of cases with postoperative HITS diminished in the 24-36 h after CEA except for preoperative HITS-positive patients. About half of our patients undergoing CEA with preoperative HITS might have another embolic source.
KW - Carotid endarterectomy
KW - Carotid stenosis
KW - High intensity transient signals
KW - Middle cerebral artery
KW - Transcranial Doppler
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=1942499603&partnerID=8YFLogxK
U2 - 10.1159/000075780
DO - 10.1159/000075780
M3 - Article
C2 - 14707411
AN - SCOPUS:1942499603
VL - 17
SP - 123
EP - 127
JO - Cerebrovascular Diseases
JF - Cerebrovascular Diseases
SN - 1015-9770
IS - 2-3
ER -