Effects of carotid artery stenting and carotid endarterectomy on cognitive function in patients with severe carotid artery stenosis

Abstract

Objective To compare the effects of carotid endarterectomy (CEA) and carotid artery stenting (CAS) on cognitive function in patients with severe carotid artery stenosis. Methods Two hundreds and sixteen severe carotid artery stenosis patients comprising 70 patients with CEA, 76 patients with CAS and 70 controls were recruited consecutively. All of them were subject to the cognitive assessment including Mini-mental State Examination (MMSE), the Chinese version Montreal Cognitive Assessment (MoCA) and event related potential P300 pre- and post-treatment for 3 months. Results During the 3-month follow-up period, patients who underwent CEA(MMSE: 27.10±1.62, MoCA: 24.16±1.81) or CAS (MMSE: 26.70±1.52, MoCA: 23.58±1.78)exhibited significant improvements in cognitive function compared with pre-treatment(MMSE: 26.31±1.38, MoCA: 23.21±1.39; MMSE: 25.95±1.44, MoCA: 22.85±1.51; all P=0.000). It did not show significant difference in the control group when comparing the pre- with the post-treatment. The improvement in MoCA score and reduction in P300 (ms)incubation in CEA(0.94±0.90, 22.09±21.85)seemed more obvious than those in CAS(0.73±0.78, 18.80±25.41), although the difference was not statistically significant. Conclusion The findings of this study suggest that both CEA and CAS have a significant effect on cognitive function in patients with severe carotid artery stenosis. Key words: Carotid stenosis; Endarterectomy, carotid; Stents; Cognition disorders; Neuropsychological tests