Effects of Carotid Artery Stent and Carotid Endarterectomy on Cognitive Function in Patients with Carotid Stenosis

Abstract

Background. Carotid artery stenosis is closely related to cognitive dysfunction, in which decreased cerebral perfusion is one of the important factors. Both carotid artery stent implantation and carotid endarterectomy can relieve stenosis and increase cerebral perfusion. In this study, we aimed to compare the effects of carotid artery stent implantation and endarterectomy on cognitive function. Methods. A total of 98 patients with carotid artery stenosis hospitalized in our hospital from July 2015 to January 2017 were included. Among them, 50 cases underwent carotid artery stent implantation treatment as stent implantation group (CAS group), and 48 cases underwent carotid artery endarterectomy treatment as carotid endarterectomy group (CEA group). Using the Mini-Mental State Examination Scale (MMSE Scale) and the Montreal Cognitive Assessment Scale (MoCA Scale), the cognitive function scores of the two groups of patients before and after 3 and 6 months of operation were measured, and the patients were also measured before and after surgery, after the serum NSE, hs-CRP content. Results. The serum NSE, hs-CRP content, MMSE score, and MoCA score of the two groups before treatment were not statistically significant ( $P>0.05$ ). The MMSE score and MoCA score of the two groups of patients before treatment were lower than the normal value, suggesting carotid artery stenosis combined with different degrees of cognitive dysfunction. Carotid artery stenosis is different, and patients’ cognitive function is also different. The MMSE score and MoCA score of the two groups at 3 and 6 months after operation were higher than before treatment, and there was a statistically significant difference between 6 and 3 months after operation ( $P<0.05$ ), but at each time There was no statistically significant difference between the two groups ( $P>0.05$ ). The NSE content of the two groups of patients after operation decreased compared with that before treatment, and the decrease in 6 months after operation was more obvious than that in March ( $P<0.05$ ). However, the difference between the two groups at each time point was not statistically significant ( $P>0.05$ ). The content of hs-CRP in the two groups of patients was higher than that before the operation, and the CAS group was significantly higher than the CEA group; the difference was statistically significant ( $P<0.05$ ). Conclusion. Carotid artery stent and carotid endarterectomy are effective in improving the cognitive function of patients with carotid stenosis, but there is no significant difference between the two.