Revascularization of Asymptomatic Carotid Artery Stenosis

Does revascularization of severe asymptomatic carotid artery stenosis improve cognition? In this analysis of secondary outcomes from randomized clinical trials comparing carotid artery stenting (CAS) or carotid endarterectomy (CEA) with intensive medical management that included 2165 participants, there were no significant differences in cognitive function at 4 years of follow-up between treatment groups (adjusted composite cognitive z scores for the revascularization vs medical therapy alone groups were 0.22 vs 0.18, respectively, for the CAS trial and 0.25 vs 0.23, respectively, for the CEA trial). Revascularization did not have cognitive benefit for patients with asymptomatic severe carotid artery stenosis.

Corresponding Author: Ronald M. Lazar, PhD, Department of Neurology, University of Alabama at Birmingham, 1720 University Blvd, CEH 500, Birmingham, AL 35294 (rlazar@uabmc.edu).

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