Abstract 4419: Improvement of Neurocognitive Function After Carotid Artery Stenting in Patients With Chronic Internal Carotid Artery Occlusion or Critical Stenosis
Backgorund: Chronic cerebral hypoperfusion may lead to impairment in neurocognitive performance in patients with severe carotid artery stenosis (CAS) or occlusion (CAO), and the effects of carotid artery stenting on neurocognitive function were unclear.
Methods and Results: We prospectively enrolled 18 patients (7 CAS, 11 CAO) with objective ipsilateral hemisphere ischemia, in whom carotid artery stenting was attempted. A battery of 5 neuropsychological tests were applied prior to and 3 months after intervention. Procedural success was achieved in 6 of 11 CAOs and all CASs. The demographics and baseline cognitive performances were similar between the successful (group 1, n=13) and failed (group 2, n=5) patients. Significant improvement in Alzheimer Disease Assessment Scale (ADAS) (pre 9.2±8.4 vs post 6.8±6.8, p=0.011) and Mini-Mental State Examination score (pre 24.1±4.1 vs post 26.1±4.0, p=0.012), and a trend towards improvement in Color Trail test A (pre 115.0±64.0 vs post 95.1±47.2, p=0.071) were found in group 1, but not in group 2. The changes of ADAS from baseline were also significantly different between groups 1 and 2.
Conclusion: Carotid artery stenting improves neurocognitive function in CAO and severe CAS patients with ipsilateral cerebral hypoperfusion.