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Effect of hemodynamic suppression on cognitive function in patients after carotid artery stenting
Weidong Fan1,2, Kun Liu2, Xingyou Guo2
1Department of Vascular Surgery, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
Insights
Carotid artery stenting (CAS) can temporarily reduce cognitive function, especially when hemodynamic depression (HD) occurs. Preventing HD is crucial for stroke patients to improve cognitive recovery after CAS.
Area of Science:
- Neurology
- Cardiovascular Surgery
- Cognitive Science
Background:
- Carotid artery stenting (CAS) is a procedure for stroke patients.
- The impact of CAS on cognitive function, particularly concerning hemodynamic depression (HD), requires further investigation.
Purpose of the Study:
- To evaluate the effect of CAS on cognitive function in stroke patients.
- To determine the influence of hemodynamic depression (HD) on cognitive outcomes following CAS.
Main Methods:
- A cohort of 130 patients undergoing CAS between January 2019 and June 2023 were analyzed.
- Patients were categorized into hemodynamic depression (HD) and non-HD groups.
- Cognitive function was assessed using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores pre-surgery and at 1, 3, 6, and 12 months post-surgery.
Main Results:
- The incidence of HD was 51.54%.
- The HD group exhibited significantly lower MMSE and MoCA scores at 3, 6, and 12 months post-CAS compared to the non-HD group (P<0.05).
- Attention, computation, and memory were impaired in the HD group, while the non-HD group showed cognitive improvement at 6 and 12 months.
Conclusions:
- CAS can lead to a transient decline in cognitive function, with potential for improvement.
- Hemodynamic depression (HD) significantly exacerbates cognitive impairment and prolongs recovery after CAS.
- Preventing HD is critical for optimizing cognitive outcomes in stroke patients undergoing CAS.
Background:
This study examines the impact of carotid artery stenting (CAS) on cognitive function in stroke patients, particularly in relation to hemodynamic depression (HD).
Methods:
Patients undergoing CAS between January 1, 2019 and June 1, 2023 were included in our study. Depending on whether hemodynamic depression happened, they were separated into two groups: HD and non-HD. Prior to surgery, one month, three months, six months, and a year following surgery, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), and cognitive function scores were compared.
Results:
130 patients were included in the study, with an HD incidence rate of 51.54%. The comparison of MMSE and MoCA scores revealed that the HD group showed declining cognitive function post-surgery (P<0.05). Specifically, the MMSE and MoCA scores were significantly lower in the HD group compared to the non-HD group at 3, 6, and 12 months after CAS (P<0.05). Additionally, attention, computation, and memory were significantly lower in the HD group at these time points (P<0.05). The non-HD group demonstrated improvement in MMSE and MoCA scores compared to preoperative levels at 6- and 12-months post-surgery (P<0.05).
Conclusions:
Following CAS, patients' cognitive ability would briefly drop before returning to baseline and improving even more. Clinical focus should be given to HD prevention because its presence would exacerbate the cognitive function impairment and lengthen the recovery period.
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