Treatment of carotid stenosis and cognitive impairment

Background. Stenotic lesions of cerebral arteries of atherosclerotic genesis predispose to the development of cognitive disorders; carotid stenosis plays a special role in these disorders. The severity of cognitive dysfunction after correction of carotid stenosis is an important consideration. Objective. To determine the dynamics of cognitive functions in patients with carotid artery stenosis before and after carotid endarterectomy, as well as risk factors for cognitive disorders. Design and Methods. The study was based on the observations of 73 patients with carotid stenosis who underwent eversion carotid endarterectomy (CEA). All patients underwent neuropsychological testing including the Mini-Cog test. The first group included 29 patients who scored 2–3 points on the Mini-Cog test. The second group consisted of 44 patients who scored 4–5 points. Results. The most significant impact on cognitive disorders in patients with carotid stenosis is caused by grade III hypertension (OR = 12.8; CI 3.97–41.2). Type 2 diabetes mellitus has no less influence on the development of cognitive impairment (OR = 8.13; CI 2.3–28.7). Other risk factors include post-infarction cardiosclerosis, which also predisposes to cognitive impairment (OR = 6.88; CI 0.73-65.02). Conclusion. Carotid endarterectomy in patients with carotid stenosis is associated with a positive dynamic regarding cognitive dysfunction. The main risk factors for cognitive disorders after surgery are grade III arterial hypertension and diabetes mellitus.

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