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. 2017 Dec;33(4):146-155.
doi: 10.5758/vsi.2017.33.4.146. Epub 2017 Dec 31.

Neuropsychological Outcome One Year after Carotid Revascularization: A before-and-after Study

Laura Casas-Hernanz  1   2 , Maite Garolera  3 , Dolors Badenes  1 , Salvador Quintana  4 , Susana Millán  5 , Noemi Calzado  1 , Jorge de Francisco  1 , Josep Royo  6 , Miquel Aguilar  1
Affiliations

Neuropsychological Outcome One Year after Carotid Revascularization: A before-and-after Study

Laura Casas-Hernanz et al. Vasc Specialist Int. 2017 Dec.

Abstract

Purpose: The aim of our study was to determine the clinical profile of patients considered cognitive 'responders' to surgery in order to establish clinical variables associated with a favorable cognitive performance.

Materials and methods: A total of 70 patients were included in the study. A well-validated, comprehensive standardized neurocognitive battery of tests of about 2 hours was administered. Patients were examined twice, 1-week before surgery and 1-year postoperatively. The criterion to be included in the 'responder' group was the following: to obtain a positive difference between post-revascularization and pre-revascularization neuropsychological assessment ≥1 standard deviation in ≥2 tests.

Results: Twenty-seven patients (38.6%) were cognitive responders to treatment. In bivariate analysis between responders and non-responders, presence of atrophy (P=0.003), small vessels (P=0.577), symptoms (P=0.046), and age (P=0.030) were the factors statistically significant. When comparing cognitive performance before and after carotid revascularization, significant differences were observed in semantic fluency with a lower performance after 12 months (P=0.004, d=0.29), and in the Language index (Repeatable Battery for the Assessment of Neuropsychological Status) (P=0.005, d=0.34).

Conclusion: Patients without neurological symptoms, of a younger age and without atrophy and white matter small vessel lesions are better cognitive responders 1-year after carotid revascularization.

Keywords: Angioplasty; Carotid stenosis; Cognition; Endarterectomy; Neuropsychological tests.

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Conflict of interest statement

Conflict of interest: None.

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