J Clin Neurol.  2015 Apr;11(2):149-156. 10.3988/jcn.2015.11.2.149.

Effect of Carotid Artery Stenting on Cognitive Function in Patients with Carotid Artery Stenosis: A Prospective, 3-Month-Follow-Up Study

• Yoon BA
• Sohn SW
• Cheon SM
• Kim DH
• Cha JK
• Yi S
• Park KW

• KMID: 2242659
• DOI: http://doi.org/10.3988/jcn.2015.11.2.149

Abstract

BACKGROUND AND PURPOSE
Carotid artery stenting (CAS) is emerging as an alternative to carotid endarterectomy for the treatment of carotid artery stenosis (CS), but the effect of CAS on the cognitive function of patients with severe CS has not been fully investigated. The aim of this study was to use comprehensive neuropsychological tests to determine the effect of CAS on cognitive function from baseline to 3 months postprocedure in patients with severe CS.
METHODS
Thirty-one patients due to undergo CAS due to high-grade CS (> or =70%) and 11 control subjects who were diagnosed with CS, but who did not undergo CAS, and who visited the clinic or emergency room between February 2009 and February 2012 were recruited consecutively at baseline (i.e., pre-CAS). Follow-up neuropsychological evaluations after 3 months were completed by 23 of the 31 patients who underwent CAS, and by 10 of the 11 control subjects. The primary cognitive outcome was assessed using a neuropsychological test containing subcategories designed to test general cognitive function, attention, visuospatial function, language and related functions, memory, and frontal lobe/executive function.
RESULTS
Of the 23 patients undergoing CAS who completed the 3-month follow-up tests, 12 had asymptomatic CS. During the 3-month follow-up period, the patients who underwent CAS and those with asymptomatic CS achieved similar results to the control group on all cognitive tests. However, symptomatic CS patients (n=11) who underwent CAS exhibited improvements in visuospatial function (p=0.046) and total Seoul Neuropsychological Screening Battery-Dementia Version scores (p=0.010) in comparison with both the asymptomatic CS patients and the control group.
CONCLUSIONS
The findings of this study suggest that CAS has a positive effect on cognitive function in patients with symptomatic CS over a 3-month follow-up period. A long-term, multicenter, prospective case-control study would be helpful to predict quality of life and prognoses for patients undergoing CAS.

Keyword

carotid artery; stenosis; stenting; cognition; visuospatial; prospective

MeSH Terms

Carotid Arteries*
Carotid Stenosis*
Case-Control Studies
Cognition
Constriction, Pathologic
Emergency Service, Hospital
Endarterectomy, Carotid
Follow-Up Studies
Humans
Mass Screening
Memory
Neuropsychological Tests
Prognosis
Prospective Studies*
Quality of Life
Seoul
Stents*

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