Оцінка якості життя та когнітивних порушень у пацієнтів із атеросклеротичним ураженням екстракраніальних артерій

Abstract

Introduction. Cognitive impairments are typical for the patients with both symptomatic and asymptomatic stenosis of the internal carotid artery (ICA), and quality of life assessment is one of important criteria for evaluating treatment effectiveness.The aim of the research was to assess quality of life and cognitive impairments in the patients with extracranial arterial lesions.Materials and methods. In the study, 85 patients were analyzed: Group I included 30 patients with symptomatic ICA stenosis; Group II comprised 40 patients with asymptomatic ICA stenosis; Group III included 15 patients with vertebralsubclavian steal syndrome (VSSS) whose quality of life and cognitive impairments were studied before surgery and 6 months after arterial reconstruction.Results. According to the Mini-Mental State Examination (MMSE) before surgery, cognitive impairments of various degree of severity were observed in all the groups. In the patients with symptomatic ICA stenosis, mild cognitive impairments were statistically significant as compared to asymptomatic patients. When comparing quality of life parameters in the postoperative period, statistically significant (p<0.05) indicators were found in the patients with symptomatic ICA stenosis and those with VSSS.In the patients with steal syndrome, positive changes occurred due to revascularization of the affected artery, that, in its turn, led to the elimination of steal syndrome, while in the patients with symptomatic ICA stenosis, the improvement of life of quality was primarily due to the regression of neurologic deficit. The psycho-emotional component of quality of life was the highest in the patients with asymptomatic ICA stenosis both in the preoperative and postoperative period. Conclusions. When assessing cognitive functions in the postoperative period, in each studied group, there was observed cognitive improvement without statistical significance. Reliable improvement of quality of life was observed in the patients with symptomatic stenosis of the internal carotid artery and vertebral-subclavian steal syndrome.