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Sixty-four asymptomatic patients with unilateral 70%to 90%internal carotid artery stenosis were investigated prospectively(mean follow-up,72 weeks). Five patients developed ischemic symptoms attributable to the stenosis (transient ischemic attack,2 patients;stroke,3 patients).A microembolic rate of>/=2 per hour in the ipsilateral middle cerebral artery was associated with a substantially increased risk of developing ischemia of the corresponding carotid territory(odds ratio,31:95%confidence interval,3 to 302,P=.005).This prospective pilot study suggests that cerebral microembolism detected with transcranial Doppler sonography may define a high-risk subgroup among patients with asymptomatic high-grade internal carotid artery stenosis. |
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