Asymptomatic Carotid Artery Stenosis, Cognitive Function, and the Impact of Carotid Revascularization: A Narrative...

The association between asymptomatic carotid artery stenosis and impaired cognition, and the cognitive changes after revascularization remain active areas of interest in the field of carotid disease. This narrative review focuses on the association between carotid artery atherosclerosis and impaired cognitive function, proposed mechanisms, and the effects of carotid revascularization on cognition.

A critical review of the literature to identify studies evaluating carotid artery stenosis, cognition, and carotid revascularization was performed using PubMed to query the MEDLINE database through March 2023.

Many studies demonstrate a link between carotid disease and cognitive impairment but direct evidence is lacking. Revascularization may offer cognitive benefits but the effect is likely subtle and affected by the choice of revascularization procedure.

Integrating cognitive outcomes into ongoing randomized controlled trials such as the nested CREST-H arm of the CREST-2 trial hold promise for offering new insight into the role of carotid artery stenosis and carotid revascularization on cognition.