Treatment of symptomatic vertebrobasilar artery stenosis with stent-assistant angioplasty in the elderly

Yan, Yongmin; Liu, Liang; Chen, Tao; Zhong, Changyang; Li, Peng

doi:10.1590/s0104-42302012000400011

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Monitoring of blood flow velocity by using TCD showed the hemodynamics of the lesioned vessels was also significantly improved, and this improvement remained over time. (2) CAS reduces the incidence of asymptomatic cerebral infarction; the stent may prevent the shedding of atheromatous plaques, which then reduces the risk for stroke due to the shedding of atheromatous plaques [29]. In addition, the protective umbrella further reduces the incidence of intraoperative embolization and decreases the incidence of cerebral infarction, which may prevent infarction-induced cognition impairment.…”

Section: Discussionmentioning

confidence: 99%

Influence of Carotid Artery Stenting on Cognition of Elderly Patients with Severe Stenosis of the Internal Carotid Artery

et al. 2014

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BackgroundThe aim of this study was to investigate the influence of carotid artery stenting (CAS) on the cognition and quality of life of elderly patients with severe stenosis of the internal carotid artery.Material/Methods65 elderly patients with symptomatic severe stenosis of internal carotid artery were recruited into 2 groups: the pharmacotherapy group (n=29) and the CAS group (n=36). Before surgery and 1, 3, 6, and 12 months after surgery, Montreal cognitive assessment (MoCA) was used for the evaluation of cognition and WHOQOL-BREF was used for the assessment of quality of life.ResultsAt 12 months after surgery, total MoCA score and WHOQOL-BREF score in the pharmacotherapy group was significantly reduced when compared with those before surgery (P<0.05). In the CAS group, the total MoCA score, scores of attention and delayed recall, and WHOQOL-BREF score increased significantly at different time points after surgery when compared with those before surgery (P<0.05). Moreover, in CAS group, the MoCA score and WHOQOL-BREF markedly increased gradually over time (P<0.05). Compared with the pharmacotherapy group, cognition and quality of life in the CAS group were improved dramatically during the follow-up period (P<0.05).ConclusionsSevere stenosis of the internal carotid artery is a cause of cognition impairment, and CAS may improve cognition and quality of life.

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Section: Discussionmentioning

confidence: 99%

Influence of Carotid Artery Stenting on Cognition of Elderly Patients with Severe Stenosis of the Internal Carotid Artery

et al. 2014

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“…Severe arterial stenosis is usually accompanied by microembolism, resulting in formation of multiple small infarcts [29]. Improvement of arterial stenosis to increase the cerebral blood flow may also effectively prevent the shedding of plaques due to the support by the stents, which further reduce the risk for recurrent stroke [6], decrease the incidence of cerebral infarction, and attenuate the deterioration of cognitive dysfunction due to cerebral infarction. In the present study, 26 patients with SVAS received SAA.…”

Section: Discussionmentioning

confidence: 99%

Influence of stent-assisted angioplasty on cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis

et al. 2014

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BackgroundWe aimed to investigate cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis (SVAS) after stent-assisted angioplasty (SAA) and to explore the potential mechanism.Material/MethodsThe study subjects were 26 elderly SVAS patients who were non-responsive to pharmacotherapy and received SAA (study group) and 30 patients receiving intracoronary stent implantation (control group). Montreal cognitive assessment (MoCA), Hamilton depression rating scale (HAMD), and Hamilton anxiety rating scale (HAMA) were used.ResultsThe total MoCA score, scores of line connection, copying cube, drawing clock, and delayed recall increased significantly in the study group after surgery (P<0.05, P<0.01). In addition, the MoCA score increased over time and the total MoCA score at 12 months was markedly higher than that at 1 month (P<0.05). The scores of HAMD and HAMA decreased dramatically after surgery compared with before surgery in these patients (P<0.01). A comparison at the corresponding period was performed between study group and control group, and it was found that the differences in total MoCA scores and scores of line connection, copying cube, drawing clock, and delayed recall before surgery and at 1 month after surgery were significant (P<0.05, P<0.01).ConclusionsSAA may improve the visuospatial/executive abilities and delayed recall, as well as the depression and anxiety in patients with SVAS. Larger and controlled trails are needed to investigate the effect of SAA on cognition and affection in these patients.

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“…[25] Moreover, the incidence of asymptomatic cerebral infarction is also reduced by carotid artery stenting, and together with distal filtering devices, shedding of atheromatous plaques and consequently distal cerebral infarction may be prevented. [26] Donepezil hydrochloride is a new generation of nootropics and works by selectively inhibiting degradation of acetylcholine in the central nervous system for improving memory and thinking abilities, with a wide range of indications due to its high safety. Carotid artery stenting and medication alone with Donepezil hydrochloride can both improve the cognitive level and living quality in patients with severe carotid atherosclerotic stenosis, [27] however, our study showed that carotid artery stenting for severe carotid stenosis was significantly better than medication with Donepecil hydrochloride alone in improving the cognitive function..…”

Section: Discussionmentioning

confidence: 99%

Effects of carotid artery stenting on cognitive impairment in patients with severe symptomatic carotid artery stenosis

et al. 2022

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The effect of carotid artery stenting and medication on improvement of cognitive function in patients with severe symptomatic carotid artery stenosis is unknown. To investigate the effect of stenting compared with medication alone for severe carotid atherosclerotic stenosis on cognitive impairment. Patients with carotid stenosis and cognitive impairment were prospectively randomly divided into 2 groups of stenting or medication alone. Cognitive function was evaluated with the Montreal cognitive assessment (MoCA), Mini-Mental State Examination, and Barthel Index of Activities of Daily Living (BI). Continuous data in normal distribution were tested with the t-test but with the Mann-Whitney U test if not in normal distribution. Categorical data were presented as frequency and percentages and tested with the Fisher exact test. A P value < .05 was regarded as statistical significant. Carotid artery stenting was successfully performed in all patients (100%) in the stenting group. Compared with before treatment, the Mini-Mental State Examination, MoCA and BI scores at 6 months in the medication alone group and at 1, 3, and 6 months in the stenting group were significantly ( P < .005) improved. The stenting group had significantly ( P < .05) better scores than the medication alone group at the same time. At 6-month follow-up, the visuospatial/executive functions (3.69 ± 1.42 vs 2.42 ± 1.23), attention (5.24 ± 1.52 vs 3.63 ± 1.47), and language (2.64 ± 0.71 vs 1.96 ± 0.69) were significantly ( P < .05) improved in the stenting group compared with the medication alone group. Carotid artery stenting may significantly improve cognitive impairment and neurological function compared with medication alone in patients with severe carotid atherosclerotic stenosis concurrent with cognitive impairment.

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Treatment of symptomatic vertebrobasilar artery stenosis with stent-assistant angioplasty in the elderly

Abstract: SAA is a safe and effective strategy for the treatment of symptomatic vertebrobasilar artery stenosis in the elderly.

Cited by 4 publications

References 16 publications

Influence of Carotid Artery Stenting on Cognition of Elderly Patients with Severe Stenosis of the Internal Carotid Artery

Influence of Carotid Artery Stenting on Cognition of Elderly Patients with Severe Stenosis of the Internal Carotid Artery

Influence of stent-assisted angioplasty on cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis

Effects of carotid artery stenting on cognitive impairment in patients with severe symptomatic carotid artery stenosis

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