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Cognitive changes after carotid artery stenting

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

We aimed to test changes in cognitive performance after carotid artery stenting (CAS).

Method

Ten patients were neuropsychologically tested at least 24 h before and 48 h after CAS. To diminish thromboembolic events, we used a proximal protection device. The following neuropsychological tests were selected: The Mini Mental State Examination (MMSE), symbol digit test and subtests of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) battery (verbal fluency, constructional practice, word list memory and delayed recall). Affective state was determined by the Beck Depression Score (BDS).

Results

No patient suffered from depression (BDS <1) or dementia (MMSE 29.9±1.5). Nine of the ten patients (P=0.12) showed increased speed in the Number Connection Test (NCT) (corresponding to trail making test). Most patients showed better or similar results concerning delayed recall (P=0.31). No change was observed in the symbol digit test, word list memory, verbal fluency or constructional practice. Better results concerning NCT and delayed recall after carotid stenting might be due to improved brain perfusion.

Conclusion

After CAS, cognitive and memory performance seem to improve. Further studies with different time intervals and more refined testing, as well as perfusion-weighted imaging, are needed.

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References

  1. Lunn S, Crawley F, Harrison MJ, Brown MM, Newman SP (1999) Impact of carotid endarterectomy upon cognitive functioning. A systematic review of the literature. Cerebrovasc Dis 9(2):74–81

    Article  PubMed  CAS  Google Scholar 

  2. Fearn SJ, Hutchinson S, Riding G, Hill-Wilson G, Wesnes K, McCollum CN (2003) Carotid endarterectomy improves cognitive function in patients with exhausted cerebrovascular reserve. Eur J Vasc Endovasc Surg 26(5):529–536

    Article  PubMed  CAS  Google Scholar 

  3. Antonelli Incalzi R, Gemma A, Landi F, Pagano F, Capparella O, Snider F, Manni R, Carbonin P (1997) Neuropsychologic effects of carotid endarterectomy. J Clin Exp Neuropsychol 19(6):785–794

    Article  PubMed  CAS  Google Scholar 

  4. Ucles P, Almarcegui C, Lorente S, Romero F, Marco M (1997) Evaluation of cerebral function after carotid endarterectomy. J Clin Neurophysiol 14(3):242–249

    Article  PubMed  CAS  Google Scholar 

  5. Pearson S, Maddern G, Fitridge R (2003) Cognitive performance in patients after carotid endarterectomy. J Vasc Surg 38(6):1248–1252; discussion 1252–1253

    Article  PubMed  Google Scholar 

  6. Brand N, Bossema ER, Ommen MvM, Moll FL, Ackerstaff RG (2004) Left or right carotid endarterectomy in patients with atherosclerotic disease: ipsilateral effects on cognition? Brain Cogn 54(2):117–123

    Article  PubMed  CAS  Google Scholar 

  7. Heyer EJ, Adams DC, Solomon RA, Todd GJ, Quest DO, McMahon DJ, Steneck SD, Choudhri TF, Connolly ES (1998) Neuropsychometric changes in patients after carotid endarterectomy. Stroke 29(6):1110–1115

    PubMed  CAS  Google Scholar 

  8. Heyer EJ, Sharma R, Rampersad A, Winfree CJ, Mack WJ, Solomon RA, Todd GJ, McCormick PC, McMurtry JG, Quest DO, Stern Y, Lazar RM, Connolly ES (2002) A controlled prospective study of neuropsychological dysfunction following carotid endarterectomy. Arch Neurol 59(2):217–222

    Article  PubMed  Google Scholar 

  9. Lee TM, Ho DS, Chan CC (1999) Preliminary neuropsychological outcomes of angioplasty and stenting of extracranial cerebral arteries. Percept Mot Skills 1:267–270

    Article  Google Scholar 

  10. Moftakhar R, Turk AS, Niemann DB, Hussain S, Rajpal S, Cook T, Geraghty M, Aagaard-Kienitz B, Turski PA, Newman GC (2005) Effects of carotid or vertebrobasilar stent placement on cerebral perfusion and cognition. Am J Neuroradiol 26(7):1772–1780

    PubMed  Google Scholar 

  11. Archie JP, Feldman RW (1981) Critical stenosis of the internal carotid artery. Surgery 89:67–72

    PubMed  Google Scholar 

  12. Kishikawa K, Kamouchi M, Okada Y, Inoue T, Ibayashi S, Iida M (2003) Effects of carotid endarterectomy on cerebral blood flow and neuropsychological test performance in patients with high-grade carotid stenosis. J Neurol Sci 213(1-2):19–24

    Article  PubMed  Google Scholar 

  13. Pugsley W, Klinger L, Paschalis C, Treasure T, Harrison M, Newman S (1994) The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning. Stroke 25(7):1393–1399

    PubMed  CAS  Google Scholar 

  14. Stump DA, Rogers AT, Hammon JW, Newman SP (1996) Cerebral emboli and cognitive outcome after cardiac surgery. J Cardiothorac Vasc Anesth 10(1):113–118; quiz 118–119

    Article  PubMed  CAS  Google Scholar 

  15. Gauvrit JY, Delmaire C, Henon H, Debette S, al Koussa M, Leys D, Pruvo JP, Leclerc X (2004) Diffusion/perfusion-weighted magnetic resonance imaging after carotid angioplasty and stenting. J Neurol 251(9):1060–1067

    Article  PubMed  Google Scholar 

  16. Flach HZ, Ouhlous M, Hendriks JM, Van Sambeek MR, Veenland JF, Koudstaal PJ, Van Dijk LC, Van Der Lugt A (2004) Cerebral ischemia after carotid intervention. J Endovasc Ther 11(3):251–257

    Article  PubMed  Google Scholar 

  17. Jacobs A, Neveling M, Horst M, Ghaemi J, Kessler J, Eichstaedt H, Rudolf J, Model P, Bönner H, de Vivie ER, Heiss WD (1998) Alterations of neuropsychological function and cerebral glucose metabolism after cardiac surgery are not related only to intraoperative microembolic events. Stroke 29:660–666

    PubMed  CAS  Google Scholar 

  18. Barth A, Remonda L, Lovblad KO, Schroth G, Seiler RW (2000) Silent cerebral ischemia detected by diffusion-weighted MRI after carotid endarterectomy. Stroke 31:1824–1828

    PubMed  CAS  Google Scholar 

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department for Diagnostic and Interventional Neuroradiology, University of the Saarland, 66424, Homburg, Germany

    I. Q. Grunwald, M. Politi, T. Struffert, C. Krick & M. Backens

  2. Clinic for Psychiatry and Psychotherapy, University of the Saarland, Homburg, Germany

    T. Supprian, P. Falkai & W. Reith

Authors
  1. I. Q. Grunwald
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  2. T. Supprian
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  3. M. Politi
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  4. T. Struffert
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  5. P. Falkai
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  6. C. Krick
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  7. M. Backens
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  8. W. Reith
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Correspondence to I. Q. Grunwald.

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Grunwald, I.Q., Supprian, T., Politi, M. et al. Cognitive changes after carotid artery stenting. Neuroradiology 48, 319–323 (2006). https://doi.org/10.1007/s00234-006-0064-5

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  • DOI: https://doi.org/10.1007/s00234-006-0064-5

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