Effect of carotid artery stenting on cognitive function in patients with carotid artery stenosis: preliminary results.
OBJECTIVE
Stenosis of the carotid artery may be a cause of reduced cognitive performance that can be ameliorated with placement of a stent. The goal of this study was to measure cognitive performance and speed of psychomotor performance prospectively before and after carotid stent placement.


METHODS
Patients referred for stent placement for a unilateral carotid artery stenosis were enrolled in the study. Neuropsychologic testing was performed with a Mini-Mental State Examination, an extended mental status examination, a subjective cognitive status measure, and a psychomotor performance test for speed. The severity of the stenosis was measured on angiograms performed before stent placement. Three months after stent placement, CT angiograms were performed and the neuropsychologic testing was repeated. Differences in neuropsychologic test scores before and after stent placement were calculated and tested for significance with a Student t test.


RESULTS
Seventeen patients with a single unilateral carotid stenosis of more than 50% completed the study. Stenosis of the carotid artery averaged 80% before treatment and 18% after treatment. After stenting, the scores from the extended mental status examination improved significantly. The scores from the subjective cognitive status measure also improved. No significant change was noted in the scores from the Mini-Mental State Examination or in the speed of psychomotor performance.


CONCLUSIONS
Carotid stent placement in patients with a unilateral stenosis of the carotid artery resulted in significant improvement in cognitive test scores in this highly selected patient group. Further studies are needed to confirm these preliminary observations.
Turk
A S
AS
Department of Radiology, University of Wisconsin Hospital and Clinics, Madison, Wis., USA. as.turk@hosp.wisc.edu
Chaudry
I
I
Haughton
V M
VM
Hermann
B P
BP
Rowley
H A
HA
Pulfer
K
K
Aagaard-Kienitz
B
B
Niemann
D B
DB
Turski
P A
PA
Levine
R L
RL
Strother
C M
CM
D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D016893:Carotid Stenosis / Q000150:complications* / Q000601:surgery*; D003072:Cognition Disorders / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015607:Stents; D016896:Treatment Outcome