Cognitive changes after surgery vs stenting for carotid artery stenosis.

Objectives: Cognitive function has not been evaluated systematically in the context of carotid endarterectomy (CEA) versus carotid artery stenting (CAS). Cognitive decline can occur from microembolization or hypoperfusion during CEA or CAS. Carotid revascularization may, however, also improve cognitive dysfunction resulting from chronic hypoperfusion.

Duplex ultrasound velocity criteria for the stented carotid artery.

Objectives: Ultrasound velocity criteria for the diagnosis of in-stent restenosis in patients undergoing carotid artery stenting (CAS) are not well established. In the present study, we test whether ultrasound velocity measurements correlate with increasing degrees of in-stent restenosis in patients undergoing CAS and develop customized velocity criteria to identify residual stenosis > or =20%, in-stent restenosis > or =50%, and high-grade in-stent restenosis > or =80%.

Methods: Carotid angiograms performed at the completion of CAS were compared with duplex ultrasound (DUS) imaging performed immediately after the procedure.