Long-term cognitive and multimodal imaging outcomes after carotid artery stenting vs intensive medication alone for severe asymptomatic carotid stenosis

• DOI: 10.1016/j.jfma.2021.02.007
• Publication Date: 2021-03-03T04:03:05Z
• Authors: Chun-Jen Lin; Feng-Chi Chang; Chung-Jung Lin; Yi-Chia Liaw; Pei-Chi Tu; Pei-Ning Wang; Jeffrey L. Saver; I-Hui Lee
• Keywords: Carotid stenting; Stroke

Severe carotid stenosis is associated with cognitive impairment, which may be attributed to asymptomatic microembolism and/or chronic hypoperfusion. We aim evaluate the long-term and brain connectivity outcomes of artery stenting (CAS) for ≥70% extracranial internal (ICA). conducted a non-randomized controlled study compare intensive medical therapy alone (Med) or in combination composite vascular events, neuropsychological, multimodal magnetic resonance perfusion imaging diffusion tensor outcomes. Sixty-nine patients were followed mean 2.3 years (31 Med, 38 CAS) 11 had events all-cause death, ischemic stroke, myocardial infarction (6 Med vs 5 CAS). Forty-six subjects completed neuropsychological multimodality follow-ups (23 23 Compared group, CAS group modest improvement 12-item delayed verbal memory (8.9 ± 2.4 9.8 2.7 9.0 2.1 8.9 2.3, p = 0.04), but not global cognition, attention executive function, was increased structural fractional anisotropy at ipsilateral deep white matter. Importantly, correlated increment middle cerebral territory. For steno-occlusion, successful revascularization addition treatment potentially benefit reserve strength are partly restoration non-critical