Neurocognitive Changes After Carotid Revascularization According to Perfusion Parameters: A Meta-analysis of Current Literature

Zhang, Xiaoqiang; Ma, Hao; Li, Lin; Zou, Junjie; Jiao, Yuanyong; Miao, Shuying; Yang, Hongyu

doi:10.1016/j.avsg.2019.01.008

Cited by 6 publications

(2 citation statements)

References 48 publications

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“…After CEA or CAS operation, the ocular vessel densities on both operated and nonoperated sides increased. Previous studies obtained similar results, in which unilateral carotid revascularization improved the cerebral perfusion and metabolism not only of the ipsilateral cerebral hemisphere but also of the contralateral cerebral hemisphere [4,29,30]. In an earlier examination, Lee et al recruited 20 patients with severe carotid stenosis, and OCTA was performed before CAS and one month after that.…”

Section: Discussionmentioning

confidence: 79%

Optical Coherence Tomography Angiography as a Noninvasive Assessment of Cerebral Microcirculatory Disorders Caused by Carotid Artery Stenosis

Zhu

Zhou

et al. 2021

Disease Markers

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Purpose. Using retinal optical coherence tomography angiography (OCTA), we aimed to investigate the changes in important indicators of cerebral microcirculatory disorders, such as the properties of the radial peripapillary capillaries, vascular complexes, and the retinal nerve fiber layer, caused by carotid stenosis and postoperative reperfusion. Methods. In this prospective longitudinal cohort study, we recruited 40 carotid stenosis patients and 89 healthy volunteers in the First Affiliated Hospital of Harbin Medical University (Harbin, China). Eyes with ipsilateral carotid stenosis constituted the experimental group, while the fellow eyes constituted the contralateral eye group. Digital subtraction angiography, CT perfusion imaging (CTP), and OCTA examinations were performed in all subjects. The vessel density of the radial peripapillary capillaries (RPC), superficial retinal vascular complexes (SVC), deep vascular complexes (DVC), choriocapillaris (CC), and the thickness of the retinal nerve fiber layer (RNFL) were assessed. Propensity-matched analysis was undertaken to adjust for covariate imbalances. Intergroup comparative analysis was conducted, and the paired sample t -test was used to evaluate the preoperative and postoperative changes in OCTA variables. Results. The ocular vessel density in the experimental group was significantly lower than that in the control group (RPC: 55.95 vs. 57.24, P = 0.0161 ; SVC: 48.65 vs. 52.22, P = 0.0006 ; DVC: 49.65 vs. 57.50, P < 0.0001 ). Participants with severe carotid stenosis have reduced contralateral ocular vessel density (RPC 54.30; SVC 48.50; DVC 50.80). Unilateral stenosis removal resulted in an increase in vessel density on both sides, which was detected by OCTA on the 4th day (RPC, P < 0.0001 ; SVC, P = 0.0104 ; DVC, P = 0.0104 ). Moreover, the ocular perfusion was consistent with that established by CTP. Conclusion. OCTA can be used for sensitive detection and accurate evaluation of decreased ocular perfusion caused by carotid stenosis and may thus have the potential for application in noninvasive detection of cerebral microcirculation disorders. This trial is registered with NCT04326842.

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Section: Discussionmentioning

confidence: 79%

Optical Coherence Tomography Angiography as a Noninvasive Assessment of Cerebral Microcirculatory Disorders Caused by Carotid Artery Stenosis

Zhu

Zhou

et al. 2021

Disease Markers

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“…Most notably, the majority of previous research has solely used paper‐based cognitive tests to examine cognitive impact. Neuroimaging methods on the other hand can more sensitively detect functional brain changes arising from revascularization, while also helping prognostically, to identify patients with the most risks of cognitive decline and dementia (Zhang et al., 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Functional MRI evaluation of cognitive effects of carotid stenosis revascularization

et al. 2022

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Introduction:Severe internal carotid stenosis, if left untreated, can pose serious risks for ischemic stroke and cognitive impairments. The effects of revascularization on any aspects of cognition, however, are not well understood, as conflicting results are reported, which have mainly been centered on paper-based cognitive analyses. Here, we summarized and evaluated the publications to date of functional MRI (fMRI) studies that examined the mechanisms of functional brain activation and connectivity as a way to reflect cognitive effects of revascularization on patients with carotid stenosis. Methods: A PubMed and Google Scholar (covering the relevant literature until November 1, 2021) search yielded eight original studies of the research line, including seven resting-state and one task-based fMRI reports.Results: Findings demonstrated treatment-related alterations in fMRI signal intensity and symmetry level, regional fMRI activation pattern, and functional brain network connectivity. The functional brain changes were associated largely with improvement in cognitive function assessed using standard cognitive test scores.Conclusions: These findings support the contribution of fMRI to the understanding of brain functional activation and connectivity changes revealing cognitive effects of revascularization in the management of severe carotid stenosis. The review also highlighted the importance of reproducibility through enhancing experimental designs and cognitive task applications with future research for potential clinical translation.

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Anesthesia for carotid endarterectomy

Gupta

2022

Essentials of Evidence-Based Practice of Neuroanesthesia and Neurocritical Care

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Neurocognitive Changes After Carotid Revascularization According to Perfusion Parameters: A Meta-analysis of Current Literature

Cited by 6 publications

References 48 publications

Optical Coherence Tomography Angiography as a Noninvasive Assessment of Cerebral Microcirculatory Disorders Caused by Carotid Artery Stenosis

Optical Coherence Tomography Angiography as a Noninvasive Assessment of Cerebral Microcirculatory Disorders Caused by Carotid Artery Stenosis

Functional MRI evaluation of cognitive effects of carotid stenosis revascularization

Anesthesia for carotid endarterectomy

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