Cognitive Impairement in Internal Carotid Artery Stenosis and the Influence of Therapeutical Interventions
Abstract
The paper reviews the literature on cognitive impairment in patients with internal carotid artery (ICA) stenosis, its possible causes and the influence of therapeutic interventions (carotid endarterectomy and carotid artery stenting, CEA and CAS) on cognitive function. The studies published are heterogenous in terms of patient samples, methods and results.
There is a moderate evidence that ICA stenosis is an independent risk factor in cognitive impairment. Possible mechanisms influencing cognitive function are embolization and hypoperfusion.
One recent hypothis is that cognitive dysfunction is related to impairment of cerebral haemodynamics rather than to structural changes arising out of embolization. The results of multicentre studies assessing the influence of therapeutic interventions on cognitive function have been inconclusive.
The current state of knowledge is not sufficient to have any impact on indications for therapy.