EFFECT OF CAROTID ARTERY STENTING ON COGNITIVE FUNCTION IN PATIENTS WITH CAROTID ARTERY STENOSIS

Abstract

Background: Carotid artery stenosis caused by atherosclerosis is an independent risk factor for cerebral ischemia and has also been associated with impaired cognitive function. It is reasonable to assume that treatment strategies targeting the improvement of the carotid artery stenosis may be effective for delaying the progression of cognitive impairment in patients with cerebral ischemia. As a simple procedure, carotid artery stenting is an important treatment strategy for carotid artery stenosis. Objective: To study is to investigate the effect of carotid artery stenting (CAS) on neurocognitive function in patients with carotid artery stenosis. Patients and methods: This prospective study was conducted on 45 patients with carotid artery stenosis who suffered also from cognitive impairment examined in the Neurology outpatient clinic and the Department of Neurology, Al-Azhar University Hospitals, Cairo, Egypt and Nasser Institute hospital in the period from August 2018 to February 2020. Results: The patients in the two groups did not differ with regard to baseline characteristics, educational level, vascular risk factors (VRFs) and neuropsychological examinations (NPEs) prior to therapy. There has been significant improvement in the total Montreal Cognitive Assessment (MoCA) score in both stent group and control group after 3 months of follow up. Regarding the MMSE, there has been significant improvement in the stent group only, while the improvement was not significant in the control group. There has been significant improvement in the stent group compared to the control group in MoCA percentage of change. There has been significant improvement in the visuoexecutive domain only. On the other hand, the percentage of change in the other cognitive domains improved but insignificantly. Conclusion: Our results indicated that 3 months after the procedure, carotid artery stenting (CAS) was associated with significant improvement in cognitive function in patients with carotid stenosis.