Background: Although several studies have evaluated the change of cognitive performance
after severe carotid artery stenosis, the results still remain elusive. The objective of this
study was to assess changes in cognitive function, depressive symptoms and Health Related Quality
of Life (HRQoL) after carotid stenosis revascularisation and Best Medical Treatment (BMT).
Methods: Study involved 213 patients with ≥70% carotid stenosis who underwent assessment of
cognitive function using Montreal Cognitive Assessment scale (MoCA), depressive symptoms -
using Patient Health Questionnaire-9 (PHQ-9) and HRQoL - using Medical Outcome Survey Short
Form version 2 (SF-36v2). The assessment was performed before and at 6 and 12 months followup
periods in patients who had Carotid Endarterectomy (CEA), Carotid Artery Stenting (CAS) or
received BMT only.
Results: Improvement in the total MoCA scores was observed after 6 and 12 months (p<0.001,
Kendall's W=0.28) in the CEA group. In the CAS group - after 12 months (p=0.01, Kendall's
W=0.261) whereas in the BMT group - no significant changes (p=0.295, Kendall's W=0.081) were
observed. Reduction of depressive symptoms was not found in any of the study groups. Comparing
mean SF-36v2 scores in the CEA group, there was no significant difference in any of 10 subscales.
Likewise in the CAS group - no significant difference in 9 of 10 subscales (p=0.028, η2=0.343)
was observed. Three subscales worsened in the BMT group during the 1-year follow-up period.
Conclusion: Patients with severe carotid stenosis who underwent revascularisation enhanced their
cognitive performance without exerting significant change of depressive symptoms. Preoperative
HRQoL may be maintained for at least one year in the CEA group.