Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Changes in Cognitive Functions after Carotid Endarterectomy and Carotid Stenting: A Decade-Apart Comparison

Daniel Václavík
,
Tomáš Hrbáč
,
Martin Roubec
,
Václav Procházka
ORCID logo ,
Tomáš Jonszta
,
David Pakizer
,
Tomáš Heryán
,
Roman Herzig
ORCID logo ,
David Školoudík
*
Version 1 : Received: 15 November 2023 / Approved: 16 November 2023 / Online: 16 November 2023 (10:23:48 CET)

A peer-reviewed article of this Preprint also exists.

Václavík, D.; Pakizer, D.; Hrbáč, T.; Roubec, M.; Procházka, V.; Jonszta, T.; Herzig, R.; Školoudík, D. Changes in Cognitive Functions after Carotid Endarterectomy and Carotid Stenting: A Decade-Apart Comparison. Biomedicines 2024, 12, 13. Václavík, D.; Pakizer, D.; Hrbáč, T.; Roubec, M.; Procházka, V.; Jonszta, T.; Herzig, R.; Školoudík, D. Changes in Cognitive Functions after Carotid Endarterectomy and Carotid Stenting: A Decade-Apart Comparison. Biomedicines 2024, 12, 13.

Abstract

Background: This study investigates cognitive function changes in severe carotid stenosis patients undergoing carotid endarterectomy (CEA) and carotid stenting (CAS), across two decades. Methods: We compared cognitive function within 30 days post-procedure in 267 patients (first 100 each for CEA and CAS in two periods: 2008–2012 and 2018–2022) at a single institution. Assessments used Adenbrooke's Cognitive Examination–Revised (ACE-R), Mini-Mental State Examination (MMSE), Speech Fluency Test (SFT), and Clock Drawing Test (CDT), conducted before and 30 ± 2 days after surgery. Results: Patients (mean age 67.2 years, 70%+ carotid stenosis) exhibited different cognitive changes over the periods. In 2008–2012, significant declines in MMSE (CEA, p = 0.049) and CDT (CAS, p = 0.015) were noted among asymptomatic patients. Conversely, in 2018–2022, improvements were observed in ACE-R and MMSE for both symptomatic and asymptomatic patients undergoing CEA and CAS. Conclusion: Over a decade, advancements in interventional techniques and patient management have reduced cognitive decline risks in asymptomatic carotid stenosis patients, also improving cognitive functions in both symptomatic and asymptomatic individuals.

Keywords

carotid stenosis; carotid endarterectomy; carotid artery stenting; cognitive functions

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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