Microembolic signal monitoring of TOAST-classified cerebral infarction patients

The aim of the present study was to investigate the effects of microembolic signals (MES) on post‑stroke neurological deficits, stroke recurrence and survival in patients with acute cerebral infarction (CI). Patients with acute CI were enrolled consecutively and classified etiologically into the following 4 subtypes using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification: i) Cardioembolism (CE); ii) large‑artery atherosclerosis (LA); iii) small‑vessel disease (SVD); and iv) stroke of other etiology, including other and undetermined etiologies. The MES of cerebral arteries were monitored by transcranial doppler (TCD), carotid atherosclerotic lesions were detected by color Doppler sonography and extracranial and intracranial magnetic resonance angiography were performed. Next, the severity of neurological deficits was evaluated using National Institutes of Health Stroke Scale (NIHSS) scores. Cases of stroke recurrence and post‑stroke mortality were recorded. A total of 135 patients were recruited, including 33 with CE, 49 with LA, 24 with SVD and 29 with stroke of other etiology. A significant difference in the incidence of MES was identified between the 4 subtypes (P=0.025). The occurrence of positive MES was found to markedly correlate with a history of coronary heart disease (P