Vol. 29 No. 1 (2025)
Endovascular Surgery

Asymptomatic cerebral ischemia after carotid artery stenting as a predictor of cognitive impairment

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  • O.S. Osipova,
  • A.A. Gostev,
  • S.V. Bugurov,
  • P.V. Ignatenko,
  • A.M. Chernyavskiy
O.S. Osipova
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk
Bio
A.A. Gostev
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk
S.V. Bugurov
City Clinical Hospital No. 2, Novosibirsk
P.V. Ignatenko
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk
A.M. Chernyavskiy
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk; Novosibirsk State Medical University, Ministry of Health of the Russian Federation, Novosibirsk
DOI: https://doi.org/10.21688/1681-3472-2025-1-7-17

Published 2025-04-28

Keywords

  • Brain Ischemia,
  • Carotid Artery Stenting,
  • Carotid Stenosis,
  • Cognitive Impairment,
  • Neurocognitive Tests

How to Cite

Osipova, O., Gostev, A., Bugurov, S., Ignatenko, P., & Chernyavskiy, A. (2025). Asymptomatic cerebral ischemia after carotid artery stenting as a predictor of cognitive impairment. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 29(1), 7–17. https://doi.org/10.21688/1681-3472-2025-1-7-17

Copyright (c) 2025 Osipova O.S., Gostev A.A., Bugurov S.V., Ignatenko P.V., Chernyavskiy A.M.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Objective: The study aimed to compare cognitive functions in patients with asymptomatic cerebral ischemic lesions and without cerebral ischemic lesions after carotid artery stenting (CAS).

Methods: A prospective cohort study was based on a subanalysis of 100 patients from the SIBERIA study database who underwent CAS. Patients with a history of stroke or contralateral occlusion of the internal carotid artery, with the development of a vascular event or death during 12 months of follow-up, and individuals with lost contacts were excluded from the analysis. Patients completed the MMSE (Mini-Mental State Examination) test before and after CAS stenting at 6 and 12 months. All three tests were completed by 39 patients with asymptomatic cerebral ischemic lesions and 36 patients without cerebral ischemic lesions on diffusion-weighted magnetic resonance imaging (MRI) of the brain in the early postoperative period after CAS. Pseudo-randomization was performed in a 1:1 ratio using the propensity score matching method, after which 30 patients were included in each group. The primary endpoint was the development of predementia/dementia.

Results: In the group patients with asymptomatic cerebral ischemic lesions, both a significantly lower median score on the MMSE test (26 [25; 28] versus 28 [28; 29], p < 0.001) and a greater number of patients with dementia/predementia (18 (60%) versus 7 (23.3%), p = 0.008) were found compared with the control group in 12 months after CAS. Asymptomatic cerebral ischemic lesions increased the risk of developing predementia/dementia within 12 months after CAS (RR 2.57 [1.07; 6.15], p = 0.02). The total volume of asymptomatic cerebral ischemic lesions ≥ 78 mm3 predicted a decline in cognitive functions.

Conclusion: Asymptomatic cerebral ischemic lesions after CAS significantly increased the risk of developing cognitive impairment during 12 months after procedure.

Received 20 February 2025. Revised 6 March 2025. Accepted 7 March 2025.

Funding
The study did not have sponsorship.

Conflict of interest
The authors declare no conflict of interest.

Contribution of the authors
Conception and study design: O.S. Osipova,
A.A. Gostev, S.V. Bugurov, P.V. Ignatenko, A.M. Chernyavskiy
Data collection and analysis: O.S. Osipova, A.A. Gostev, S.V. Bugurov
Statistical analysis: O.S. Osipova, A.A. Gostev, S.V. Bugurov
Drafting the article: O.S. Osipova, A.A. Gostev
Critical revision of the article: P.V. Ignatenko,
A.M. Chernyavskiy
Final approval of the version to be published: O.S. Osipova, A.A. Gostev, S.V. Bugurov, P.V. Ignatenko, A.M. Chernyavskiy

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