Key result
Carotid stenting and EC-IC bypass linked to improved cognitive performance at 3 months over medical therapy.
Why the study?
The neuropsychological consequences after carotid artery stenting and extracranial-intracranial by-pass were not well compared.
Does carotid artery stenting or extracranial-intracranial by-pass improve cognitive function in patients with carotid or intracranial stenosis?
Cohort (n=118)
No
Does carotid artery stenting or extracranial-intracranial by-pass improve cognitive function in patients with carotid or intracranial stenosis?
Carotid artery stenting and extracranial-intracranial by-pass may improve cognitive function and activities of daily living at 3 months in patients with carotid or intracranial stenosis.
Both procedures were associated with 3-month cognitive gains in this small cohort; hypothesis-generating and requires randomized confirmation before practice change.
Background: To compare the neuropsychological consequences after carotid artery stenting (CAS) and extracranial-intracranial by-pass (EC-IC by-pass). Methods: A total of 43 patients referred to CAS, 32 patients referred to EC-IC by-pass and 43 control subjects were enrolled in the study. Neuropsychologic testing was performed before and three months after procedure. A paired Student t test was used to compare neuropsychologic test scores at baseline and three months after procedure in each group. Cognitive changes in a three-month follow-up were not normally distributed and compared among/between groups with Kruskal-Wallis test. Results: Three months after the treatment both the CAS and EC-IC by-pass groups showed improved cognitive performance compared to baseline, whereas the same improvement wasn’t seen in the control group. The scores from Activities of Daily Living also improved in all three groups in a three-month follow-up, and EC-IC group presented a more distinct increase in daily life abilities comparing to the other two groups. Conclusions: CAS and EC-IC by-pass in patients with a carotid or intracranial stenosis may result in cognitive improvement three months after surgery.
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Liu et al. (2015) conducted a cohort in Severe carotid or intracranial artery stenosis (n=118). Carotid Artery Stenting and Extracranial-Intracranial By-Pass vs. Medical management (declined surgery) was evaluated on Change in Mini-Mental State Examination (MMSE) score at 3 months (p=<0.001).
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