Objective: To investigate the impact of carotid interventions on patients' mental condition in patients with carotid stenosis.
Summary Background Data: Ongoing research highlights the impact of carotid interventions on neurocognitive function in patients with advanced carotid atherosclerosis. However, data regarding the impact of carotid revascularization on mood is scarce.
Methods: A total of 157 patients undergoing carotid revascularization were prospectively recruited. The primary outcome was depression, evaluated pre-operatively, and at 1-,6- and 12-month post-intervention using the long form of the geriatric depression scale (GDS-30) questionnaire. Other tests were also used to assess cognition at the respective timepoints. Statistical analyses were performed to assess the postoperative outcomes compared to baseline.
Results: Baseline depression (GDS>9) was observed in 49(31%) subjects, whereas 108(69%) patients were not depressed (GDS≤9). The average pre-operative GDS score was 15.42 ± 4.40(14.2-16.7) and 4.28 ±2.9(3.7-4.8) in the depressed and non-depressed groups, respectively. We observed a significant improvement in GDS scores within the depressed group at 1-month (P=0.002), 6-months (P=0.027), and 1-year (P<0.001) post-intervention compared to preop, whereas the non-depressed group had similar post-op GDS scores at all time points compared to baseline. Significant improvement in measures of executive function was seen in non-depressed patients at all three timepoints whereas depressed patients showed an improvement at 1-year follow-up.
Conclusions: Our study highlights improvement in mood among patients with advanced carotid disease who screened positive for depression at baseline. Further studies with larger sample sizes are warranted to investigate the association between depression, carotid disease, and carotid intervention.
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http://dx.doi.org/10.1097/SLA.0000000000006216 | DOI Listing |
Ann Indian Acad Neurol
January 2025
Departments of Clinical Neurosciences and Community Health Sciences, The Hotchkiss Brain Institute, The Mathison Centre for Mental Health Research and Education, and The O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Symptomatic carotid disease, characterized by atherosclerotic or non-atherosclerotic internal carotid artery disease with ipsilateral stroke symptoms, represents a critical condition in stroke neurology. This "hot carotid" state carries a high risk of stroke recurrence, with almost one-fourth of the patients experiencing recurrent ischemic events within 2 weeks of initial presentation. The global prevalence of significant carotid stenosis (conventionally defined as ≥50% narrowing) is estimated at around 1.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA.
Background: Penetrating carotid artery injuries (CAI) are rare with high morbidity and mortality. We aimed to perform a systematic review of the published literature to evaluate the workup and management of penetrating CAI.
Methods: Studies of acute management of adult trauma patients with penetrating common or internal carotid artery injuries on MEDLINE or EMBASE from 1946 through July 2024 were included following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement methodology.
Ann Vasc Surg
January 2025
Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL. Electronic address:
Introduction: Carotid artery stenosis is a significant contributor to ischemic strokes, and its surgical management includes carotid artery endarterectomy (CEA), transfemoral carotid artery stenting (TF-CAS), and trans carotid artery revascularization (TCAR). CEA has traditionally been preferred, but TF-CAS and TCAR are also excellent alternative options if the anatomy of the vessels allows them. This study reports our short- and mid-term outcomes after carotid artery revascularization in symptomatic patients at a stroke center.
View Article and Find Full Text PDFNeuroradiol J
January 2025
Department of Neuroradiology, Teaching Hospital of Paracelsius Medical University (PMU), Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy.
Occlusion of the distal internal carotid artery can simulate a proximal occlusion of its cervical tract on CT angiography in patients with acute ischemic stroke, that is, pseudo-occlusion. As true and false carotid occlusions can present similarly on non-invasive imaging in patients undergoing endovascular treatment for stroke, our study aimed to evaluate clinical and technical differences of these conditions and the possible consequences of a misdiagnosis. We retrospectively reviewed consecutive patients who underwent mechanical thrombectomy for acute ischemic stroke at a single center between July 2015 and May 2022 and included patients with absent opacification of the cervical carotid artery on CT-angiography.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
January 2025
From the Department of Radiology (J.L., E.A.B., C.B., J.C., R.K., W.B., D.F.K), and Department of Neurologic Surgery (Y.C.S., R.K., W.B.), Mayo Clinic, Rochester, MN, United States; Department of Stroke Research (J.L.), Vall d'Hebron Research Institute, Barcelona, Spain; From the Global Institute of Future Technology (Y.L.), Shanghai Jiao Tong University, Shanghai, China; Department of Neurointerventional Radiology (J.C.), Bicetre University Hospital, Le Kremlin Bicetre, France.
Background And Purpose: Proximal protection devices, such as TransCarotid Artery Revascularization (TCAR, SilkRoad Medical, Sunnyvale), aim to yield better outcomes in carotid artery stenting (CAS) than distal protection devices by preventing plaque embolization to the brain. However, transfemoral catheters may not fully reverse flow from the external carotid artery (ECA) to the internal carotid artery (ICA). We assess a new balloon-sheath device, Femoral Flow Reversal Access for Carotid Artery Stenting (FFRACAS), for this purpose.
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