Optimized prevention of stroke: What is the role of ultrasound?

Abstract

Major cardio- and cerebrovascular events often occur in individuals without known preexisting cardiovascular disease. The prevention of such events, including the accurate identification of those at risk, remains a serious public health challenge. Scoring equations to predict those at increased risk have been developed using cardiovascular risk factors, but they tend to overestimate the risk in low-risk populations and underestimate it in high-risk populations. This overview discusses the possible role of ultrasound for an optimized prevention of stroke and focusses on (1) the importance of embolic signals in asymptomatic carotid stenosis, (2) the detection of unstable carotid plaques using duplex ultrasonography, and (3) the role of the ankle–brachial index for the stroke risk prediction in the acute stage and for secondary prevention.