Background: The risk of cognitive decline in patients undergoing carotid endarterectomy (CE)
for left internal carotid artery (ICA) (LICA) disease before or after the occurrence
of ischemic symptoms has not been fully elucidated. We evaluated whether patients
undergoing CE for symptomatic LICA stenosis have greater risk of cognitive decline
than patients with asymptomatic LICA disease or right ICA disease. Methods: In a series of patients aged 65 years and older, consecutively undergoing CE and
free from cognitive impairment, cognitive function was evaluated through the age-
and education-adjusted Mini Mental State Examination and the Clock Drawing Task at
baseline and at the end of the study period (average follow-up: 44.4 ± 14.3 months).
Results: The analysis included 103 patients (mean age 72.6 ± 7.0 years; 73 men), of whom 50
had LICA disease (29 symptomatic). At the end of the study period, Mini Mental State
Examination score was reduced in patients with symptomatic LICA disease (P < .001) but not in other patients, whereas the Clock Drawing Task score was reduced
in both patients with LICA and right ICA. Patients with symptomatic LICA disease had
greater risk of cognitive decline than other individuals, either measured by the Mini
Mental State Examination score (F = 5.18, P = .002) or by the Clock Drawing Task score (F = 9.42, P = .001). Conclusions: Patients undergoing CE for symptomatic LICA disease appear to be at increased risk
of cognitive decline than other individuals. Further studies are needed to confirm
these findings and to evaluate whether LICA endarterectomy before occurrence of cerebrovascular
ischemic symptoms may provide additive benefit in the prevention of cognitive decline.
Key Words
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Article info
Publication history
Accepted:
June 30,
2005
Received:
June 5,
2005
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2005.06.003
Copyright
© 2005 National Stroke Association. Published by Elsevier Inc. All rights reserved.
