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Updated: May 27, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Impact of silent ischemic lesions on cognition following carotid artery stenting
Kuo-Lun Huang1, Meng-Yang Ho, Chien-Hung Chang
1Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan, ROC.
Objective:
The occurrence of silent ischemic lesions (SILs) is a common finding after carotid artery stenting (CAS). This study aimed to evaluate the impact of SILs on cognitive functioning following CAS.
Methods:
The retrospective study separated 131 patients with unilateral carotid stenosis into three groups: medication only, MRI-evaluated CAS and CT-evaluated CAS, and compared the sociodemographic factors, post-CAS images and Mini-Mental State Examination scores performed before and 6-12 months after enrollment.
Results:
Seven minor strokes occurred in the 99 patients receiving CAS. SILs were detected in 12 of 55 patients with diffusion-weighted MR imaging (DWI) and in 3 of 37 patients with CT 1 week after CAS. In patients with DWI follow-up, the frequency of SILs was 8, 24, 43 and 60% in patients with 0-, 1-, 2- and 3-vessel coronary artery disease (p = 0.006). The frequency of SILs on DWI was 0, 32 and 33% in patients with improved, unchanged, or deteriorated cognitive functioning (p = 0.02). Such an association was not observed if based on SILs on CT or manifesting stroke.
Conclusion:
The presence of coronary artery disease increases the risk for having post-CAS SILs, and the occurrence of SILs may be associated with cognitive changes after CAS.
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