Comparison of Microembolism Detected by Transcranial Doppler and Neuropsychological Sequelae of Carotid Surgery and Percutaneous Transluminal Angioplasty

• DOI: 10.1161/01.str.31.6.1329
• Publication Date: 2011-06-17T20:08:03Z
• Authors: Francesca Crawley; Jan Stygall; Sarah Lunn; Michael Harrison; Martin M. Brown; Stanton Newman
• Keywords: Transcranial Doppler; Endarterectomy

Background and Purpose —Percutaneous transluminal angioplasty (PTA) is currently being assessed for the treatment of carotid stenosis. In comparison with endarterectomy (CEA), there evidence an increased risk cerebral microembolism during procedure. We have sought any neuropsychological sequelae PTA compared it CEA to demonstrate relative safety 2 options. Methods —The outcomes after were in matched groups patients severe symptomatic stenosis, 96% whom had been randomized Carotid Vertebral Artery Transluminal Angioplasty Study (CAVATAS), at a single center. Transcranial Doppler insonation middle artery was used measure reactivity response carbon dioxide inhalation before then detect microembolization ipsilateral hemisphere changes blood flow velocity procedures. The performance on test battery administered before, 6 weeks after, months procedure 20 undergoing 26 having CEA. Results —At weeks, 5 each group showed similar decline performance; global measures no significant difference between procedures, despite significantly higher incidence microemboli PTA. Both marked reduction anxiety treatment. Conclusions findings provide some reassurance that not associated greater complications than CEA, embolic load recorded by transcranial ultrasonography angioplasty.