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Cognitive testing in patients undergoing carotid endarterectomy

C D Irvine1, F V Gardner, A H Davies

  • 1Department of Surgery, Bristol Royal Infirmary, U.K.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|May 20, 1998
PubMed
Summary

Carotid endarterectomy (CEA) effects on cognition remain unclear due to limited controlled studies. Further research needs standardized testing and appropriate follow-up for patients with carotid arterial disease.

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Area of Science:

  • Neurology
  • Vascular Surgery
  • Cognitive Science

Background:

  • Carotid arterial disease poses risks to cognitive function.
  • Carotid endarterectomy (CEA) is a surgical intervention for this condition.
  • The impact of CEA on cognition requires thorough investigation.

Purpose of the Study:

  • To review literature on CEA's effect on cognitive function in patients with carotid arterial disease.
  • To identify recommendations for standardizing cognitive testing in this patient group.

Main Methods:

  • Literature search of English language studies from 1986-1995 using MEDLINE.
  • Keywords: carotid endarterectomy, cognitive function.
  • Selection of relevant papers and backward citation searching.

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Main Results:

  • Few controlled studies exist on CEA's cognitive impact.
  • No consensus on whether CEA improves or impairs cognition.
  • Methodological flaws include lack of control groups and practice effects in positive studies.
  • Early follow-up in studies suggesting impairment is noted.

Conclusions:

  • Significant methodological issues plague studies on cognitive function pre- and post-CEA.
  • Disagreement exists in interpreting study results.
  • Future studies require control groups, practice-resistant tests, and appropriate timing post-surgery.