title: Impact of silent ischemic lesions on cognition following carotid artery stenting.
abstract: OBJECTIVE
  The occurrence of silent ischemic lesions (SILs) is a common finding after carotid artery stenting (CAS). This study aimed to evaluate the impact of SILs on cognitive functioning following CAS.
  
  
  METHODS
  The retrospective study separated 131 patients with unilateral carotid stenosis into three groups: medication only, MRI-evaluated CAS and CT-evaluated CAS, and compared the sociodemographic factors, post-CAS images and Mini-Mental State Examination scores performed before and 6-12 months after enrollment.
  
  
  RESULTS
  Seven minor strokes occurred in the 99 patients receiving CAS. SILs were detected in 12 of 55 patients with diffusion-weighted MR imaging (DWI) and in 3 of 37 patients with CT 1 week after CAS. In patients with DWI follow-up, the frequency of SILs was 8, 24, 43 and 60% in patients with 0-, 1-, 2- and 3-vessel coronary artery disease (p = 0.006). The frequency of SILs on DWI was 0, 32 and 33% in patients with improved, unchanged, or deteriorated cognitive functioning (p = 0.02). Such an association was not observed if based on SILs on CT or manifesting stroke.
  
  
  CONCLUSIONS
  The presence of coronary artery disease increases the risk for having post-CAS SILs, and the occurrence of SILs may be associated with cognitive changes after CAS.
authors: Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan, ROC.
authors: Kuo-Lun
authors: KL
authors: Huang
authors: Meng-Yang
authors: MY
authors: Ho
authors: Chien-Hung
authors: CH
authors: Chang
authors: Shan-Jin
authors: SJ
authors: Ryu
authors: Ho-Fai
authors: HF
authors: Wong
authors: I-Chang
authors: IC
authors: Hsieh
authors: Ting-Yu
authors: TY
authors: Chang
authors: Tai-Cheng
authors: TC
authors: Wu
authors: Tsong-Hai
authors: TH
authors: Lee
authors: Yeu-Jhy
authors: YJ
authors: Chang
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology*; D002339:Carotid Arteries / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D002533:Cerebral Angiography; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed