Carotid stenting improves cognitive function in asymptomatic cerebral ischemia
Ying-Hsien Chen1, Mao-Shin Lin, Jen-Kuang Lee
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
International Journal of Cardiology
|November 18, 2011
Summary
Successful carotid stenting (CS) in patients with asymptomatic internal carotid artery (ICA) stenosis and cerebral ischemia improved cognitive function. This neurocognitive enhancement was observed in patients with successful stenting, unlike those with failed procedures or normal perfusion.
Area of Science:
- Neurology
- Vascular Surgery
- Neuroimaging
Background:
- Asymptomatic critical internal carotid artery (ICA) stenosis can lead to cognitive impairment.
- Carotid stenting (CS) is a potential intervention, but its effect on neurocognitive function remains debated.
Purpose of the Study:
- To evaluate the impact of carotid stenting (CS) on neurocognitive function in patients with asymptomatic internal carotid artery (ICA) stenosis.
- To determine if successful CS improves cerebral perfusion and cognitive outcomes in this patient group.
Main Methods:
- Prospective enrollment of 34 patients with unilateral ICA stenosis or occlusion undergoing CS.
- Pre- and post-procedure assessments included computed tomography cerebral perfusion (CTP) and neuropsychological tests (MMSE, ADAS-Cog, etc.).
- Patients were stratified into three groups based on CTP findings and procedural success.
Main Results:
- Successful CS was achieved in 82% of patients.
- Group II (ipsilateral ischemia with successful CS) showed significant improvements in ADAS-Cog, MMSE, and Color Trail Test A scores.
- No significant cognitive changes were noted in patients with failed CS or normal baseline CTP.
Conclusions:
- Successful carotid stenting significantly improves neurocognitive function in asymptomatic patients with ICA stenosis and objective ipsilateral cerebral ischemia.
- The findings support CS as a beneficial intervention for cognitive enhancement in select patients with significant carotid stenosis.
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