Neurocognitive Improvement After Carotid Artery Stenting in Patients With Chronic Internal Carotid Artery Occlusion
| Autor: | Jiyao Jiang, Yong Wang, Yi-ling Fan, Jie-qing Wan, Lei Chen, Zheng-wen Zhou, Qing Yao |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Ischemia Perfusion scanning Revascularization Brain Ischemia Internal medicine medicine.artery Occlusion medicine Humans Carotid Stenosis Prospective Studies Aged business.industry Montreal Cognitive Assessment General Medicine Thrombolysis medicine.disease Surgery Radiography Treatment Outcome Carotid artery occlusion Chronic Disease Cardiology Feasibility Studies Female Stents Patient Safety Internal carotid artery Cognition Disorders Cardiology and Cardiovascular Medicine business Carotid Artery Internal |
| Zdroj: | Vascular and Endovascular Surgery. 48:305-310 |
| ISSN: | 1938-9116 1538-5744 |
| DOI: | 10.1177/1538574414525863 |
| Popis: | Symptomatic internal carotid artery (ICA) occlusion with hemodynamic impairment remains a dismal disease when untreated. In this prospective, single-center, controlled study, we investigated the feasibility, safety, and long-term outcome of stenting by endovascular recanalization for patients with chronic ICA occlusion. Forty patients with symptomatic chronically occluded ICA were assigned to receive endovascular recanalization (group A, n = 18) or conservative management (group B, n = 22). The primary end point was 100% complete recanalization of the primary occlusion at 60 minutes, and secondary end points were improvement in neurologic function and cognitive function. Patients in the 2 groups were comparable in demographic and baseline characteristics. Successful recanalization was achieved in 88.9% (16 of 18) of patients with the restoration of Thrombolysis in Myocardial Ischemia/Thrombolysis in Cerebral Ischemia 2 or 3 flow. There was no procedural or new cerebral ischemic event. Improvement in brain perfusion was observed in 12 (12 of 18, 75%) patients on single-photon emission computed tomography. Improvement in neurologic function defined as a reduction of ≥4 points on the National Institutes of Health Stroke Scale (NIHSS) at 6 months was observed in group A (baseline, 6.83 ± 3.01 vs 6 months, 2.61 ± 1.20; P < .01) and group B (baseline, 6.05 ± 2.75 vs 6 months, 4.77 ± 1.69; P < .05). A significant difference in NIHSS scores was noted between group A and B at 1, 3, and 6 months ( P < .05 or .001). Improvement in cognitive function defined as an increase of ≥8 on the Montreal Cognitive Assessment (MoCA) was observed in group A at 3 and 6 months (baseline, 14.67 ± 3.56 vs 3 months, 24.17 ± 3.55 and 6 months, 24.72 ± 2.85; P < .01). Significant improvement in MoCA was also observed in group B ( P < .01). Furthermore, a significant difference in MoCA scores was noted between group A and B at 1, 3, and 6 months ( P < .05 or .001). Endovascular recanalization is feasible and safe for patients with symptomatic chronic carotid artery occlusion. Successful carotid artery stenting can improve neurological function and global cognitive function than nonrevascularization. |
| Databáze: | OpenAIRE |
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