CHICAGO, Nov. 28 /PRNewswire/ -- Stenting of the carotid artery
significantly improves cognitive speed and may improve memory function in some
patients, according to research presented today at the annual meeting of the
Radiological Society of North America (RSNA).
"To my knowledge this is the first study combining neuropsychological
testing and perfusion imaging that screens for silent ischemic stroke events
that can occur during stenting," said Iris Q. Grunwald, M.D., consultant at
Saarland University Clinic in Homburg, Germany.
Stroke is the third leading cause of death in the United States. Every
year, approximately 600,000 Americans experience a stroke, one-quarter of
which are caused by carotid arterial occlusive disease, or a narrowing of the
carotid arteries. Until recently, surgery was the standard treatment for this
disease, but carotid artery stenting has emerged as an accepted minimally
invasive alternative to restore blood flow to the brain.
To perform the procedure, an interventional radiologist inserts a long
catheter into a tiny incision in the common femoral artery in the leg. Using
an image-guidance system such as computed tomography (CT) and a guide wire,
the radiologist positions the sheath at the site of the narrowing, or
stenosis, in the carotid artery, expands the artery with a balloon and inserts
a stent to hold the artery open.
While stenting is known to be an effective treatment for stroke
prevention, little is known on the treatment's effects on cognitive function.
Dr. Grunwald and colleagues performed carotid artery stenting on
26 patients. All were given neuropsychological tests at least 24 hours before
and three months after the stenting procedure. These tests included tests for
cognitive speed (how quickly the brain processes information) and memory
function. Patients were also tested for dementia and depression. The
researchers examined the patients with diffusion- and perfusion-weighted
magnetic resonance imaging (MRI) before and after stenting.
The results showed that cognitive speed increased significantly after
stenting, regardless of the patient's age or the severity of the stenosis. In
addition, the researchers found a correlation between the degree of vessel
stenosis and perfusion deficit, or decreased blood flow, in the brain area on
the side of the stenosis. Increasing the blood flow by stenting resulted in
an increase in memory function in patients with perfusion deficit.
"Stenting is a safe way to treat carotid artery stenosis," Dr. Grunwald
said. "In addition, stenting of the carotid artery may offer more than
reduced stroke risk, especially to patients with impaired brain perfusion."
Co-authors are Wolfgang Reith, M.D., Tillman Supprian, M.D., Peter Falkai,
M.D., Christoph Krick, Ph.D., Tobias Struffert, M.D., Kathrin Zercher, Verena
Fedder and Friederike Winnemann.
RSNA is an association of more than 38,000 radiologists, radiation
oncologists, medical physicists and related scientists committed to promoting
excellence in radiology through education and by fostering research, with the
ultimate goal of improving patient care. The Society is based in Oak Brook,
Ill.
AT A GLANCE
-- Carotid artery stenting not only helps prevent stroke, it speeds up
the brain's thought process.
-- Stenting is a minimally invasive procedure that effectively treats
narrowing of the carotid arteries.
-- In patients with decreased blood flow to the brain, carotid artery
stenting improves memory function.
SOURCE Radiological Society of North America
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