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BACKGROUND AND PURPOSE: Few studies investigated the neuropsychological outcome after carotid angioplasty with stent placement (CAS), yielding partially inconsistent results. Softwarecrackworks Zip File Password Protected there. The present investigation evaluated the effect of CAS in patients with high-grade stenosis and assessed the predictive value of ischemic lesion number for postinterventional cognitive deterioration. METHODS: 22 patients were tested neuropsychologically before and six weeks after CAS. Cerebral ischemic changes were assessed with diffusion weighted imaging (DWI) prior to and after angioplasty.

RESULTS: Pre- to postinterventional cognitive performance improved significantly in terms of verbal memory (t = -2.30; p. Introduction High-grade carotid stenosis as well as asymptomatic narrowing of the carotid arteries due to atherosclerosis may cause global cerebral hypoperfusion and thus result in cognitive dysfunction –. A regularization of the cerebral perfusion however is thought to be associated with improved cognitive functioning,. On the other hand, surgical interventions like carotid endarterectomy (CEA) as well as endovascular treatments like percutaneous transluminal angioplasty (PTA) or carotid angioplasty with stenting (CAS) hold a risk of subsequent complications and might lead to cognitive deterioration as well. The emergence of PTA in 1974 initiated a debate concerning alternative procedures to carotid surgery. Although the applied materials and techniques have been dramatically improved since that time, the optimized choice in methods is currently still being evaluated –. Whereas the advantages of endovascular interventions over CEA include shorter hospitalization and an avoidance of minor surgical complications, which occur in about 10% in case of CEA, carotid PTA has been criticised for causing significantly more microembolism as inferred from transcranial Doppler,.

In the context of cardiac surgery, there is some evidence that neuropsychological outcome is related to microembolic load. Accordingly, one might suggest that carotid PTA might cause disproportionate cognitive impairment in comparison to CEA. A recently conducted study by Witt and colleagues assessed the neuropsychological outcome after CEA and CAS in 24 and 21 patients, respectively, who were assigned randomly to the different treatments. Both groups achieved comparable results on the neuropsychological testbattery that was administered before, as well as 6 and 30 days after intervention.

Accordingly, CAS was not found to be associated with greater cognitive deterioration than CEA. These results agree well with the empirical data conveyed by an other study, reporting no significant group differences in the cognitive domain when assessed six weeks and six months after CAS and CEA, respectively. Studies evaluating the precise extent to which cognitive functioning is altered after PTA and CAS are rare, and report at least partially inconsistent findings. Lehrner and colleagues compared 20 patients suffering from high-grade carotid stenosis before and 6 months after unilateral stent-protected carotid angioplasty with regard to their neurocognitive status.