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Detection of microembolic signals (MES) by transcranial Doppler is the only way to evaluate the effect of antithrombotic agents on circulating thrombi in vivo. The effect of antithrombotic agents on MES from various embolic sources was determined. First, the effect of antiplatelet agents on MES from carotid lesions was investigated. MES counts in some patients with carotid lesions decreased after antiplatelet administration. MES detection is enormously useful for evaluating antiplatelet therapy in patients with carotid lesions, since MES are detected frequently and reflect real thrombi in these patients. On the other hand, MES from artificial organs, such as mechanical valves and ventricle assisted systems, usually reflect air bubbles. Detection of MES from artificial organs does not represent the effect of anticoagulation therapy. Recently, several papers have reported a decrease in air bubbles due to oxygen inhalation. This method may make it possible to distinguish thrombi and air bubbles. MES from atrial fibrillation, the aorta, or persistent follamen ovale, are rare. MES detection was not useful for the evaluation of therapy in such patients.
日本脳神経超音波学会の論文