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Vol. 66, No. 6, 2011
Issue release date: December 2011
Eur Neurol 2011;66:351–358

Impact of Silent Ischemic Lesions on Cognition following Carotid Artery Stenting

Huang K.-L. · Ho M.-Y. · Chang C.-H. · Ryu S.-J. · Wong H.-F. · Hsieh I.-C. · Chang T.-Y. · Wu T.-C. · Lee T.-H. · Chang Y.-J.
aStroke Center and Department of Neurology, bMedical Imaging and Intervention, and cInternal Medicine, Second Section of Cardiology, Chang Gung Memorial Hospital, dGraduate Institute of Behavioral Sciences, and eCollege of Medicine, Chang Gung University, Tao-Yuan, Taiwan, ROC

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Objective: The occurrence of silent ischemic lesions (SILs) is a common finding after carotid artery stenting (CAS). This study aimed to evaluate the impact of SILs on cognitive functioning following CAS. Methods: The retrospective study separated 131 patients with unilateral carotid stenosis into three groups: medication only, MRI-evaluated CAS and CT-evaluated CAS, and compared the sociodemographic factors, post-CAS images and Mini-Mental State Examination scores performed before and 6–12 months after enrollment. Results: Seven minor strokes occurred in the 99 patients receiving CAS. SILs were detected in 12 of 55 patients with diffusion-weighted MR imaging (DWI) and in 3 of 37 patients with CT 1 week after CAS. In patients with DWI follow-up, the frequency of SILs was 8, 24, 43 and 60% in patients with 0-, 1-, 2- and 3-vessel coronary artery disease (p = 0.006). The frequency of SILs on DWI was 0, 32 and 33% in patients with improved, unchanged, or deteriorated cognitive functioning (p = 0.02). Such an association was not observed if based on SILs on CT or manifesting stroke. Conclusion: The presence of coronary artery disease increases the risk for having post-CAS SILs, and the occurrence of SILs may be associated with cognitive changes after CAS.

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