Effects of Carotid Artery Stent (CAS) on Cognitive Function in Patients with Symptomatic Carotid Stenosis using MoCa Scale and Neuroimaging Test

Objectives: This prospective study aimed to assess the safety and efficacy of carotid angioplasty with stent (CAS) and its consequential impact on cognitive function, and to identify predisposing factors affecting cognitive response. Materials and Methods: A total of 49 patients (median age 71.52, 80.8% male) who underwent CAS between January 2020 and August 2021 were analyzed. Cognitive evaluations utilized the MoCa scale, and neuroimaging was employed to detect neurological incidents, with comprehensive documentation of risk factors and comorbidities. Results: Stent placement achieved a 93.8% success rate. Post-CAS neuroimaging disclosed multifocal ischemia in 8.16% of patients, microhemorrhages in 8.16%, and focal ischemia in 32.65%, with no clinically relevant deficits noted. A significant association (p=0.015) between severe stenosis and multifocal ischemic neurological events was observed. Cognitive improvements were evidenced in 53.8% of patients postoperatively, with kidney disease and cervical radiotherapy negatively correlated with cognitive response, while higher education level demonstrated a positive correlation. Conclusions: CAS is established as a secure and efficient procedure, influencing cognitive function. The recognized predisposing factors contribute to enhanced patient selection and treatment strategy. Delving into the connection between these aspects and subsequent cognitive performance necessitates further investigation.