Abstract:

Recently, concerns about cognitive impairment and its association with carotid artery stenosis have been raised up progressively. Carotid artery stenting (CAS) is a well-established method which has been widely applied for ischemic stroke. However, its impact on cognitive function remains controversial. CAS can improve cognitive function by reducing the incidence of ischemic stroke and improving hemodynamic status, while postoperative microembolic events can lead to increased cognitive impairment. In addition, the effect of CAS on cognitive function is also affected by many other factors, including white matter hyperintensity (WMH), cerebral microbleeds (CMBs), depression, advanced age, etc. Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis-Hemodynamics (CREST-H) is expected to provide a clearer understanding of the therapeutic effects of CAS in cognitive function in conclusion.

Key words: Carotid stenosis, Angioplasty, Stents, Cognition disorders, Review

摘要：

颈动脉狭窄与认知功能障碍的关系为近年临床研究关注的焦点，颈动脉支架成形术预防缺血性卒中的效果已经大量临床试验所证实，但其对认知功能的影响尚存争议。颈动脉支架成形术可通过降低缺血性卒中发生率、改善脑血流动力学而改善认知功能，但术后微栓塞事件使认知功能障碍进一步加重，而脑白质高信号、脑微出血、抑郁症、高龄等则使术后认知功能障碍的风险增加。期望正在进行的颈动脉血运重建与药物治疗无症状性颈动脉狭窄及血流动力学比较研究，能够为颈动脉支架成形术在改善认知功能方面的疗效带来更为明确的结论。

关键词: 颈动脉狭窄, 血管成形术, 支架, 认知障碍, 综述