Association between carotid revascularization for asymptomatic stenosis and cognitive functions

Area of Science:

• Neurology
• Vascular Surgery
• Cognitive Science

Background:

• Asymptomatic carotid stenosis (ACS) is linked to cognitive dysfunction via cerebral hypoperfusion and microemboli.
• Carotid revascularization procedures like angioplasty stenting (CAS) and endarterectomy (CEA) are potential treatments, but their cognitive impact is uncertain.

Purpose of the Study:

• To systematically review current evidence on the effects of carotid revascularization on cognitive function in patients with asymptomatic carotid stenosis.

Main Methods:

• A systematic literature review of studies published between January 2010 and January 2020 from Medline and Cochrane databases.
• Included studies assessed cognitive function in patients undergoing CAS or CEA for asymptomatic carotid stenosis.

Main Results:

• Twenty observational studies were included, with no randomized controlled trials found.
• Data were too heterogeneous, lacking standardization and comparison with optimal medical treatment, precluding definitive conclusions.

Conclusions:

• Current evidence is insufficient to confirm the cognitive benefits of carotid revascularization for ACS.
• Harmonized research, including randomized controlled trials, is urgently needed to address cognitive dysfunction in ACS, particularly in an aging population.