Abstract

Cognitive outcome after carotid artery stenting in patients with cerebral ischemia.

Author(s): Wei Yue, Zhihong Shi, Miao Zhang, Shuai Liu RN, ShuLing Liu RN, Ting Zhang, Xiaoguang Tong, Yuying Zhou, Yong Ji

Background: Chronic cerebral hypoperfusion may lead to cognitive decline in patients with chronic stenosis or occlusion of the cervicocerebral vessels, and the effects of stent placement on neurocognitive function have been controversial.

Methods: A series of 105 patients, who were identified with arterial stenosis or occlusion and abnormal cerebral perfusion in the area of the stenotic vessel based on computed tomography (CT) angiography or magnetic resonance angiography (MRA) and magnetic resonance (MR) or CT perfusion were selected to investigate. A battery of neuropsychological tests, including the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), were assessed 1 week before and 90 days after the cervicocerebral vessel stenting, or conventional angiography without intervention.

Results: Patients were subdivided into 2 groups (n=83 carotid artery stents [CAS]); no intervention (n=22) serving as a control group. Significant improvements in MMSE (CAS 23.9 [4.9] vs 25.4 [4.7] for before vs after the procedures; P<0.01) and in MoCA (CAS 19.9 [6.4] vs 22.0 [6.0] for before vs after the procedures; P<0.01) were observed in the intervention groups. Orientation, delayed recall and abstraction were also improved.

Conclusions: Successful cervicocerebral vessel stenting improve cognitive function in patients with cervicocerebral vessels stenosis or occlusion with a corresponding perfusion abnormality.

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