Performance cognitive in pazienti anziani sottoposti a endoarterectomia o a stenting carotideo: Studio di follow up a 12 mesi

Introduction. In this study we investigated short and long-term impact of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in cognitively healthy elderly subjects with severe carotid stenosis on several cognitive functions by neuropsychological evaluation before surgery and after three and twelve months. Methods. Cognition, mood and functional status were evaluated in 28 patients undergoing CEA (24 M, 4 F, 72.6 ± 5.8 years old) and in 29 patients undergoing CAS (17 M, 12 F, 75.1 ± 5.7 years old) by a broad spectrum of tests assessing mood, functional status, memory, attention, verbal fluency, visuospatial and constructional abilities. Results. No significant differences in scores at cognitive tests were observed three and twelve months after carotid reopening independently of the technique used. Only scores at Copy Drawing test (visuospatial and constructional abilities) slightly but significantly (p<0.05) worsened in the CAS group twelve months after intervention. No significant differences between CEA and CAS groups were detected regarding mood and functional status after 3 and 12 months. Discussion. Neither CEA nor CAS significantly affected cognitive, mood and functional status at short as well as at long-term. The choice of CAS, with a shorter hospital stay, might be indicated in elderly patients with severe carotid stenosis.