Assessment of Cognitive Functions in Patients with Carotid Stenosis Undergoing Carotid Intervention

Abstract

Extracranial carotid artery stenosis is an important cause for transient ischemic attacks and ischemic strokes. Atherosclerosis is a primary pathologic entity responsible for stenosis of the carotid artery. Carotid artery disease could be symptomatic or asymptomatic. It has been confirmed that stroke as well as carotid stenosis could result in cognitive impairment which is likely to be ignored as it is covered by the sever physical disability. The most frequent manifestations of vascular cognitive impairment are attention insufficiency and executive dysfunction. Duplex ultrasound is the preferred imaging modality for screening but DSA remains the gold standard method for detection of carotid stenosis. Treatment of carotid artery stenosis could be achieved by medical, surgical, endovascular (stenting) or combined treatments. Carotid artery stenting (CAS) had become widely used as an alternative to carotid endarterectomy (CEA) in revascularization therapy of carotid artery stenosis. Cognitive functions are being increasingly an important outcome measure that affects patient‘s wellbeing functional status and quality of life. Cerebral embolization is considered one of the main limitations of revascularization procedures which may have a negative impact on cognition. DWI-MRI brain had been extensively used to detect peri-procedural subclinical brain ischemic injury after carotid interventions