We performed Transcranial Doppler monitoring to detect microembolic signals
(MES) in 47 patients with moderate (30%-69%) carotid stenosis proven by se
lective angiography. We compared the occurrence of MES with the clinical ch
aracteristics of stenosis (symptomatic or asymptomatic) and the angiographi
c plaque features (nonulcerated, deep ulceration, superficial ulceration, u
lceration with flap, or ulceration without flap). For these cases there was
no indication for endarterectomy, nevertheless we thought it would be usef
ul to identify risk subgroups that might benefit from surgical treatment. M
ES were detected in 17.9% of the stenoses with a prevalence (p < .01) in sy
mptomatic cases (25%) compared to asymptomatic cases (14.3%). There was a s
ignificant correlation of MES with plaque ulceration (p < .01) and particul
arly with ulceration without flap (p < .01). No difference between deep and
superficial ulceration was observed. The availability of prospective data
on this topic might be useful to select subgroups of patients with moderate
carotid stenosis at risk for embolism.