Effect of hemodynamic suppression on cognitive function in patients after carotid artery stenting.

Background: This study examines the impact of carotid artery stenting (CAS) on cognitive function in stroke patients, particularly in relation to hemodynamic depression (HD).

Methods: Patients undergoing CAS between January 1, 2019 and June 1, 2023 were included in our study. Depending on whether hemodynamic depression happened, they were separated into two groups: HD and non-HD. Prior to surgery, one month, three months, six months, and a year following surgery, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), and cognitive function scores were compared.

Results: 130 patients were included in the study, with an HD incidence rate of 51.54%. The comparison of MMSE and MoCA scores revealed that the HD group showed declining cognitive function post-surgery (P<0.05). Specifically, the MMSE and MoCA scores were significantly lower in the HD group compared to the non-HD group at 3, 6, and 12 months after CAS (P<0.05). Additionally, attention, computation, and memory were significantly lower in the HD group at these time points (P<0.05). The non-HD group demonstrated improvement in MMSE and MoCA scores compared to preoperative levels at 6- and 12-months post-surgery (P<0.05).

Conclusions: Following CAS, patients' cognitive ability would briefly drop before returning to baseline and improving even more. Clinical focus should be given to HD prevention because its presence would exacerbate the cognitive function impairment and lengthen the recovery period.