Abstract
Background: To compare the neuropsychological consequences after carotid artery stenting (CAS) and extracranial-intracranial by-pass (EC-IC by-pass). Methods: A total of 43 patients referred to CAS, 32 patients referred to EC-IC by-pass and 43 control subjects were enrolled in the study. Neuropsychologic testing was performed before and three months after procedure. A paired Student t test was used to compare neuropsychologic test scores at baseline and three months after procedure in each group. Cognitive changes in a three-month follow-up were not normally distributed and compared among/between groups with Kruskal-Wallis test. Results: Three months after the treatment both the CAS and EC-IC by-pass groups showed improved cognitive performance compared to baseline, whereas the same improvement wasn’t seen in the control group. The scores from Activities of Daily Living also improved in all three groups in a three-month follow-up, and EC-IC group presented a more distinct increase in daily life abilities comparing to the other two groups. Conclusions: CAS and EC-IC by-pass in patients with a carotid or intracranial stenosis may result in cognitive improvement three months after surgery.
Highlights
Atherosclerosis of the extracranial and intracranial artery is an important mechanism underlying cerebrovascularHow to cite this paper: Liu, L. and Zhou, Y.Y. (2015) Effect of Carotid Artery Stenting and Extracranial-Intracranial By-Pass on Cognitive Function: Preliminary Results
The degree of carotid and intracranial stenosis was initially evaluated by CT angiogram (CTA), and conventional cerebral angiography was followed in anticipation of carotid artery stenting (CAS) and EC-IC by-pass
There were no significant differences in baseline Mini-Mental State Examination (MMSE), Montreal cognitive assessment (MoCA), ADLs and Hamilton Rating Scale for Depression (HMLD) scores among the groups (Table 1)
Summary
Atherosclerosis of the extracranial and intracranial artery is an important mechanism underlying cerebrovascularHow to cite this paper: Liu, L. and Zhou, Y.Y. (2015) Effect of Carotid Artery Stenting and Extracranial-Intracranial By-Pass on Cognitive Function: Preliminary Results. (2015) Effect of Carotid Artery Stenting and Extracranial-Intracranial By-Pass on Cognitive Function: Preliminary Results. Has been demonstrated to be associated with stroke [1], cognitive impairment [2] [3] and dementia [4] It can reduce cerebral perfusion [5] [6], which further causes oxidative stress, mitochondrial dysfunction, and neuroinflammation [7] [8], and eventually leads to neuropathological changes and cognitive performance decline. Results: Three months after the treatment both the CAS and EC-IC by-pass groups showed improved cognitive performance compared to baseline, whereas the same improvement wasn’t seen in the control group. Conclusions: CAS and EC-IC by-pass in patients with a carotid or intracranial stenosis may result in cognitive improvement three months after surgery
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