Literature DB >> 21836094

Neurocognitive improvement after carotid artery stenting in patients with chronic internal carotid artery occlusion and cerebral ischemia.

Mao-Shin Lin1, Ming-Jang Chiu, Yen-Wen Wu, Ching-Chang Huang, Chi-Chao Chao, Ying-Hsien Chen, Hung-Ju Lin, Hung-Yuan Li, Ya-Fang Chen, Lung-Chun Lin, Yen-Bin Liu, Chia-Lun Chao, Wen-Yih Isaac Tseng, Ming-Fong Chen, Hsien-Li Kao.   

Abstract

BACKGROUND AND
PURPOSE: Chronic cerebral hypoperfusion may lead to impairment in neurocognitive performance in patients with chronic internal carotid artery occlusion, and the effects of carotid artery stenting on neurocognitive function have been unclear.
METHODS: We prospectively enrolled 20 chronic internal carotid artery occlusion patients with objective ipsilateral hemisphere ischemia, in whom carotid artery stenting was attempted. Functional assessments, including the National Institutes of Health Stroke Scale, Barthel Index, and a battery of neuropsychological tests, including the Mini-Mental State Examination, Alzheimer Disease Assessment Scale-Cognitive Subtest, verbal fluency, and Color Trail Making A and B, were administered before and 3 months after intervention.
RESULTS: Successful recanalization was achieved in 12 of 20 patients (60%). There was no procedural or new cerebral ischemic event, except for 1 intracranial hemorrhage, which occurred during the procedure and had neurologic sequelae; this case was excluded from analysis. The demographics and baseline cognitive performance were similar between the group with a successful outcome (group 1, n=12) and patients who did not (group 2, n=7). Ten of 12 patients in group 1 had improvement in ipsilateral brain perfusion after the procedure, but none in group 2 had improvement. Significant improvement in the scores on the Alzheimer Disease Assessment Scale-Cognitive Subtest (before, 7.7±8.9 versus after, 5.7±7.1; P=0.024), Mini-Mental State Examination (before, 25.8±3.8 versus after, 27.7±2.7; P=0.015), and Color Trail Making A (before, 123.2±68.6 versus after, 99.3±51.5; P=0.017) were found in group 1 but not in group 2.
CONCLUSIONS: Successful carotid artery stenting improves global cognitive function as well as attention and psychomotor processing speed in patients with chronic internal carotid artery occlusion.

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Mesh:

Year:  2011        PMID: 21836094     DOI: 10.1161/STROKEAHA.111.613133

Source DB:  PubMed          Journal:  Stroke        ISSN: 0039-2499            Impact factor:   7.914


  20 in total

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4.  Prevention of Hippocampal Neuronal Damage and Cognitive Function Deficits in Vascular Dementia by Dextromethorphan.

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5.  Decreased ¹³N-labeled ammonia uptake in the ipsilateral and contralateral hemispheres following carotid endarterectomy.

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6.  Cognitive Performance following Carotid Endarterectomy or Stenting in Asymptomatic Patients with Severe ICA Stenosis.

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7.  Reasons underlying the consent to endovascular treatment, displayed by patients diagnosed with asymptomatic internal carotid artery stenosis.

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8.  Intravenous grafts of amniotic fluid-derived stem cells induce endogenous cell proliferation and attenuate behavioral deficits in ischemic stroke rats.

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9.  Effects of carotid artery stenting on cognitive function in patients with mild cognitive impairment and carotid stenosis.

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Review 10.  Therapeutic outcomes of transplantation of amniotic fluid-derived stem cells in experimental ischemic stroke.

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Journal:  Front Cell Neurosci       Date:  2014-08-13       Impact factor: 5.505

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