Treatment of carotid stenosis and cognitive impairment

Background . Stenotic lesions of cerebral arteries of atherosclerotic genesis predispose to the development of cognitive disorders; carotid stenosis plays a special role in these disorders. The severity of cognitive dysfunction after correction of carotid stenosis is an important consideration. Objective . To determine the dynamics of cognitive functions in patients with carotid artery stenosis before and after carotid endarterectomy, as well as risk factors for cognitive disorders. Design and Methods . The study was based on the observations of 73 patients with carotid stenosis who underwent eversion carotid endarterectomy (CEA). All patients underwent neuropsychological testing including the Mini-Cog test. The first group included 29 patients who scored 2–3 points on the Mini-Cog test. The second group consisted of 44 patients who scored 4–5 points. Results . The most significant impact on cognitive disorders in patients with carotid stenosis is caused by grade III hypertension (OR = 12.8; CI 3.97–41.2). Type 2 diabetes mellitus has no less influence on the development of cognitive impairment (OR = 8.13; CI 2.3–28.7). Other risk factors include post-infarction cardiosclerosis, which also predisposes to cognitive impairment (OR = 6.88; CI 0.73-65.02). Conclusion . Carotid endarterectomy in patients with carotid stenosis is associated with a positive dynamic regarding cognitive dysfunction. The main risk factors for cognitive disorders after surgery are grade III arterial hypertension and diabetes mellitus.