Background: The objective of this study was to review the recent literature regarding the neurocognitive consequences of carotid endarterectomy (CEA) and carotid stenting (CAS). Methods and Results: A PubMed and Web of Science search was conducted using the key words ‘carotid' in combination with ‘cognitive', ‘cognition', ‘neurocognition', ‘neurocognitive', ‘neuropsychology', and ‘neuropsychological'. Bibliographies of relevant articles were cross-referenced. We included 37 studies published since 2007 of which 18 examined CEA, 12 CAS, and 7 compared CEA to CAS. There is a wide variability in the reported neurocognitive outcome following CEA and CAS. Nonetheless, none of the included studies unveiled significant differences between CEA and CAS on postoperative neurocognitive functioning. Postoperative changes observed for CEA and CAS separately seem limited to a small percentage (around 10-15%) of patients and can either present as an improvement or impairment. Key Messages: The available data seem to suggest that no obvious cognitive differences between CAS and CEA can be observed after intervention. Both improvement and deterioration in cognitive functioning can be observed following CAS or CEA. Methodological differences such as patient heterogeneity, implementation and type of control groups, type of psychometric tests used, statistical analyses, or timing of the assessments play an important role in explaining the sometimes divergent results of the included studies. Large-scale and methodologically solid studies comparing CEA and CAS on neurocognitive outcome remain warranted. Future studies should implement adequate control groups to correct for practice effects in the target groups.

TCD recordings demonstrated a significant reduction in embolization to the brain during transcervical carotid artery stent placement with the use of dynamic flow reversal compared to transfemoral CAS using distal filters. No significant differences in microembolization could be detected between CEA and CASfr. The observed lower embolization rates and lack of adverse events suggest that transcervical CAS with dynamic flow reversal is a promising technique and may be the preferred method when performing CAS.

Patient-specific rehearsal was rated highly for both face and content validity. Access strategy, endovascular material use and angiographic imaging were all replicated effectively, although certain biomechanical vessel properties seemed to be replicated to a lesser degree. Patient-specific rehearsal constitutes a unique tool that may help tailor endovascular material choice, and optimize the preoperative preparation of the interventionalist and team.

Empathy refers to our ability to recognize and share emotions by another human being. Impairment may underlie many of the emotional deficits commonly associated with a range of neuropsychiatric and neurological conditions. The prefrontal cortex (PFC) has long been implicated in these processes, but the specific contribution of subregions of the PFC remain unclear. Studies regarding the role of subregions of the prefrontal cortex such as the ventromedial prefrontal cortex (vmPFC)-in facial emotion recognition have yielded inconsistent results. The present study aimed to investigate the capacity to recognize nonverbal emotional facial expressions in a group of patients with the following: (a) perfusion deficits in the vmPFC (vmPFC group; N = 13), (b) hypoperfusions sparing the vmPFC (nonvmPFC group; N = 12), and in (c) a control group of healthy volunteers (control group; N = 17). Regions of hypoperfusion were identified by means of Single Photon Emission Computed Tomography (SPECT). Participants were asked to recognize facial expressions of the 7 basic emotions (happiness, fear, surprise, anger, disgust, sadness, or neutral). Detection of facial expressions of fear, disgust, and surprise was affected after functional disruption of the vmPFC. The present study confirms the role of the vmPFC in recognizing emotional facial expressions.