Is there improvement of "vascular depression" after carotid artery stent placement?

Purpose: To prospectively evaluate if high-grade (> or = 80% luminal narrowing) internal carotid artery stenosis is associated with depressive symptoms and if carotid artery stent placement (CAS) potentially improves depressive symptoms.

Materials And Methods: The study was approved by the local ethics committee, and informed consent was obtained from all subjects. One hundred forty-three patients (91 men, 52 women; interquartile range, 63-76 years) undergoing CAS because of asymptomatic high-grade (> or = 80% luminal narrowing) carotid artery stenosis and 102 control subjects (64 men, 38 women; interquartile range, 63-73 years) with advanced peripheral artery disease and without carotid artery stenosis undergoing lower-limb percutaneous transluminal angioplasty were included. Substantial depressive symptoms (defined as a Beck Depression Inventory score of 10 or higher) were recorded at baseline and at 4 weeks (follow-up) after the percutaneous procedures. The chi2 test, Mann-Whitney U test, McNemar test, Wilcoxon rank sum test, and two-group t test were used to check for statistical significance.

Results: A significantly higher prevalence of depressive symptoms was found in patients with carotid artery stenosis than in control subjects with peripheral artery disease at baseline (33.6% vs 16.7%, P = .003). At follow-up, a significant reduction of depressive symptoms was found in patients who underwent CAS (33.6% vs 9.8%, P < .001). The frequency of depressive symptoms remained unaffected in control subjects (16.7% vs 13.0%, P = .1).

Conclusion: High-grade carotid artery stenosis is associated with depressive symptoms in patients with atherosclerosis. CAS seems to exert beneficial effects on the course of depressive symptoms in these patients.