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KMID : 1037520170330040146
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Vascular Specialist International
2017 Volume.33 No. 4 p.146 ~ p.155
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Neuropsychological Outcome One Year after Carotid Revascularization: A before-and-after Study
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Casas Hernanz Laura
Garolera Maite
Badenes Dolors
Quintana Salvador
Millan Susana
Calzado Noemi
De Francisco Jorge
Royo Josep
Aguilar Miquel
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Abstract
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Purpose: The aim of our study was to determine the clinical profile of patients considered cognitive ‘responders’ to surgery in order to establish clinical variables associated with a favorable cognitive performance.
Materials and Methods: A total of 70 patients were included in the study. A well-validated, comprehensive standardized neurocognitive battery of tests of about 2 hours was administered. Patients were examined twice, 1-week before surgery and 1-year postoperatively. The criterion to be included in the ‘responder’ group was the following: to obtain a positive difference between post-revascularization and pre-revascularization neuropsychological assessment ≥1 standard deviation in ≥2 tests.
Results: Twenty-seven patients (38.6%) were cognitive responders to treatment. In bivariate analysis between responders and non-responders, presence of atrophy (P=0.003), small vessels (P=0.577), symptoms (P=0.046), and age (P=0.030) were the factors statistically significant. When comparing cognitive performance before and after carotid revascularization, significant differences were observed in semantic fluency with a lower performance after 12 months (P=0.004, d=0.29), and in the Language index (Repeatable Battery for the Assessment of Neuropsychological Status) (P=0.005, d=0.34).
Conclusion: Patients without neurological symptoms, of a younger age and without atrophy and white matter small vessel lesions are better cognitive responders 1-year after carotid revascularization.
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KEYWORD
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Endarterectomy, Carotid stenosis, Angioplasty, Cognition, Neuropsychological tests
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