Neuropsychological sequelae of carotid angioplasty with stent placement: correlation with ischemic lesions in diffusion weighted imaging.
OBJECTIVE
Few studies investigated the neuropsychological outcome after carotid angioplasty with stent placement (CAS), yielding partially inconsistent results. The present investigation evaluated the effect of CAS in patients with high-grade stenosis and assessed the predictive value of ischemic lesion number for postinterventional cognitive deterioration.


METHODS
22 patients were tested neuropsychologically before and six weeks after CAS. Cerebral ischemic changes were assessed with diffusion weighted imaging (DWI) prior to and after angioplasty.


RESULTS
Pre- to postinterventional cognitive performance improved significantly in terms of verbal memory (t = -2.30; p<0.05), whereas significant deterioration was noted regarding verbal memory span (t = 2.31; p<0.05). 8 (36%) persons conformed to the criteria of cognitive improvement. 6 patients (27%) were postinterventionally classified as having deficits. Analysis yielded no statistically significant correlations between lesion quantity and cognitive change.


CONCLUSIONS
Both improvement and deterioration of cognitive functioning was observed in our collective of patients, leaving the neuropsychological outcome after percutaneous transluminal angioplasty unpredictable in individual cases. The presence of acute ischemic lesions on DWI was found to be not tightly associated with cognitive dysfunction after CAS.
Tiemann
Laura
L
Neurologische Klinik und Poliklinik der Technischen Universität München, Munich, Germany. tiemann@lrz.tu-muenchen.de
Reidt
Jutta Hubertina
JH
Esposito
Lorena
L
Sander
Dirk
D
Theiss
Wolfram
W
Poppert
Holger
H
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects*; D002339:Carotid Arteries / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology*; D003251:Constriction, Pathologic; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors