Effect Of Carotid Artery Stenting On Cognitive Function Improvement In Patients With Symptomatic Carotid Artery Stenosis

Objective To investigate the effect of carotid artery stenting on cognitive function improvement in patients with symptomatic carotid artery stenosis.Methods A total of 23 patients with symptomatic unilateral severe carotid artery stenosis who were diagnosed by the Department of Neurology,General Hospital of Ningxia Medical University from October,2019 to December,2020 were selected as the research subjects.Digital subtraction angiography(DSA)was performed on all patients after informed consent.The patients were divided into carotid stent group(16 cases)and only drug treatment group(7 cases)according to their treatment willingness.Each patient was assessed by Mini-mental State Examination(MMSE)and Montreal Cognitive Scale(Mo CA)before treatment and 1 month and 3 months after treatment.The ability of collateral compensation was evaluated by American society of interventional and therapeutic neuroradiology/society of interventional radiology(ASITN/SIR)standard.Then the effect of carotid artery stent implantation and collateral circulation opening on cognitive function were analyzed.Results 1.The MMSE and Mo CA scores of carotid artery stent group were both significant improved 1 month and 3 months after operation compared with those before treatment(P<0.05);However,there were no significant changes in MMSE and Mo CA scores in drug treatment group before and after treatment(P>0.05);During the 3-month follow-upperiod,the cognitive function of patients in the carotid artery stent group was improved more effectively by comparing the two treatments(P < 0.05).2.In the stent group,the naming function was not significantly improved at 1 month and3 months after operation(P>0.05).Except for visuospatial executive function and language function were observed to improve until 3 months after operation,the improvement of other cognitive function was observed at 1 month postoperatively(P < 0.05).3.Before the treatment,patients with good collateral circulation in both the stent group and the drug group had higher Mo CA scores than those with poor collateral circulation(P<0.05);For patients in the stent group,there was no significant difference in Mo CA score between patients with good collateral circulation and patients with poor collateral circulation(P>0.05)at 1 month follow-up after operation,and there was still no difference at 3 months postoperatively(P>0.05);For patients in the drug group,there was no significant difference in the Mo CA scores of the patients with good and poor collateral compensatory at 1 month(P<0.05)and 3 months(P<0.01)after operation.Conclusion 1.Carotid artery stenting can significantly improve cognitive function in patients with symptomatic unilateral severe carotid stenosis.No improvement was observed in naming function during the follow-up period,visuospatial executive function and language function at the 3 months,and improvement was observed in other cognitive areas at the 1month after treatment.2.Good collateral circulation can improve the cognitive function for patients with symptomatic severe carotid stenosis.