Cognitive changes after Carotid Endarterectomy

Gremigni, Paola; Sciarroni, L.; Pedrini, L

doi:10.4081/monaldi.2009.334

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…In addition, asymptomatic patients with stenosis greater than 75% experienced an improvement in cognitive function after CEA. Cognitive function increased significantly between the preoperative measurement and at 3 months following CEA in patients with and without dementia [ 33 ].…”

Section: Endarterectomy Improves Qolmentioning

confidence: 99%

Quality of life after carotid endarterectomy: a review of the literature

et al. 2017

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Strokes are one of the leading causes of death, morbidity, and disability worldwide, mainly among elderly people. It is also the third most common cause of years of life being lost, indicating a high risk of premature mortality. Revascularisation with endarterectomy (CEA) is effective in reducing the risk of death and strokes in patients with carotid artery stenosis, but the effect of invasive treatment on quality of life (QoL) still needs attention. To shed more light on the patients’ perspective on this health condition, we carried out a review of the literature which aimed to analyze the level of health-related QoL among stroke survivors, with special attention to patients who had been treated with CEA. Strokes significantly reduce the level of QoL, which may subsequently be improved in the course of treatment with CEA. Patients experience a reduced level of QoL in the early postoperative period, but at 1 year following CEA, the level of QoL remains stable and is similar to that of chronically ill patients. The domains of QoL which are most affected are physical and emotional functioning, which also serve as markers for decreased QoL in the long term. Older age and comorbidities are predictors of worse QoL. Stroke survivors require proper care both immediately after a stroke happens and during the long-term rehabilitation. Measurement of QoL and of the determining factors that contribute to a reduced level of QoL, as well as focusing on determinants of QoL in stroke survivors may help to reduce patients’ disability and improve their daily functioning in society as well as reducing the cost of health care.

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Section: Endarterectomy Improves Qolmentioning

confidence: 99%

Quality of life after carotid endarterectomy: a review of the literature

et al. 2017

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“…Patients can demonstrate cognitive changes after CEA due to the common due to the common fluctuations in CBF during and after surgery; approximately 20%–25% demonstrate cognitive dysfunction 18,23 and approximately 10%–15% demonstrate cognitive improvement, 1,2,9,11,12,39 while approximately 60%–70% demonstrate no cognitive changes. 14,40 Current unpublished data suggest that patients with reduced CBF velocity during cross-clamping of the carotid artery are more likely to exhibit cognitive dysfunction 1 day after CEA.…”

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confidence: 99%

Middle cerebral artery pulsatility index and cognitive improvement after carotid endarterectomy for symptomatic stenosis

Heyer

Mergeche²,

Connolly

2014

JNS

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Object Transcranial Doppler (TCD) is frequently used to evaluate peripheral cerebral resistance and cerebral blood flow (CBF) in the middle cerebral artery prior to and during carotid endarterectomy (CEA). Patients with symptomatic carotid artery stenosis may have reduced peripheral cerebral resistance to compensate for inadequate CBF. The authors aim to determine whether symptomatic patients with reduced peripheral cerebral resistance prior to CEA demonstrate increased CBF and cognitive improvement as early as 1 day after CEA. Methods Fifty-three patients with symptomatic CEA were included in this observational study. All patients underwent neuropsychometric evaluation 24 hours or less preoperatively and 1 day postoperatively. The MCA was evaluated using TCD for CBF mean velocity (MV) and pulsatility index (PI). Pulsatility index ≤ 0.80 was used as a cutoff for reduced peripheral cerebral resistance. Results Significantly more patients with baseline PI ≤ 0.80 exhibited cognitive improvement 1 day after CEA than those with PI > 0.80 (35.0% vs 6.1%, p = 0.007). Patients with cognitive improvement had a significantly greater increase in CBF MV than patients without cognitive improvement (13.4 ± 17.1 cm/sec vs 4.3 ± 9.9 cm/sec, p = 0.03). In multivariate regression model, a baseline PI ≤ 0.80 was significantly associated with increased odds of cognitive improvement (OR 7.32 [1.40–59.49], p = 0.02). Conclusions Symptomatic CEA patients with reduced peripheral cerebral resistance, measured as PI ≤ 0.80, are likely to have increased CBF and improved cognitive performance as early as 1 day after CEA for symptomatic carotid artery stenosis. Revascularization in this cohort may afford benefits beyond prevention of future stroke. Clinical trial registration no: NCT00597883 (ClinicalTrials.gov).

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“…Numerous studies have shown that living with a chronic disease affects the person's mental health. For example, in cerebrovascular diseases, there is permanent damage to the brain tissue caused by a somatic disorder; coronary heart disease affects the severity of depressive symptoms in surviving apoplexy [6], and the removal of the vascular pathology substrate often leads to improved cognitive function and reduced depression [7]; depression often develops as part of type-2 DM and has been identified as one of the factors that accelerates the onset of advanced degenerative changes to small blood vessels. Patients on hemodialysis face a number of difficulties brought on by the nature of the disease.…”

Section: Introductionmentioning

confidence: 99%

Mental health of patients with chronic diseases during the Coronavirus disease 2019 pandemic in Serbia - A cross-sectional study

et al. 2020

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Introduction. Since the coronavirus disease 2019 outbreak was declared a pandemic by the World Health Organization on March 11, 2020, it has become the greatest public health threat worldwide. People with chronic diseases were identified as the group at risk for fatal outcome. The purpose of this research is to estimate the mental health of patients with chronic diseases during the coronavirus disease 2019 pandemic. Material and Methods. A total of 463 individuals (50.8% female), with the average age of 46.63 years (SD = 14.29, ranging from 20 to 75 years of age) participated in the research. The subjects were divided into two groups, based on the existence of at least one chronic disease. The Depression, Anxiety and Stress Scale-21 was used to assess the mental health of the participants. The research was conducted in August 2020. The impact of chronic illness on depression, anxiety, and stress levels was assessed using linear regression models. Results. The prevalence of chronic diseases among the participants was 44.3%. The participants with chronic diseases presented with higher levels of depression (p < 0.05), anxiety (p < 0.001), and stress (p < 0.001) compared to healthy participants. The presence of chronic illness remains a significant predictor of all the dependent variables, even after the inclusion of multiple variables in the final regression model: depression (Beta [?] 0.37; 95% confidence interval: 2.67 - 4.42; p < 0.01), anxiety (Beta [?] 0.19; 95% confidence interval: 0.80 - 2.55; p < 0.01), and stress (Beta [?] 0.09; 95% confidence interval: 0.01 - 2.13; p < 0.05). Conclusion. About five months after the coronavirus disease 2019 pandemic was declared, the investigation of mental health of chronically ill adults in Serbia shows an increased amount of stress, anxiety, and depression in this subpopulation.

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Cognitive changes after Carotid Endarterectomy

Cited by 4 publications

References 23 publications

Quality of life after carotid endarterectomy: a review of the literature

Quality of life after carotid endarterectomy: a review of the literature

Middle cerebral artery pulsatility index and cognitive improvement after carotid endarterectomy for symptomatic stenosis

Mental health of patients with chronic diseases during the Coronavirus disease 2019 pandemic in Serbia - A cross-sectional study

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