Mental status outcomes following carotid endarterectomy: A six-month analysis

Abstract

Fifty-one male and two female patients were divided into the following three groups: (a) patients with symptomatic carotid artery disease who received carotid endarterectomies, (b) patients with symptomatic carotid artery disease who either declined or were not candidates for carotid endarterectomies, and (c) patients who received a surgical procedure unrelated to cerebral functioning. The three groups were not significantly different in terms of age or educational level. The subjects were examined using the WAIS, Wechsler Memory Scale, Halstead-Reitan Neuropsychological Battery, Sickness Impact Profile, and Profile of Mood States. The assessments were conducted presurgery and repeated at a 6 month follow-up. The results of two-way analyses of variance revealed a significant trials effect for a majority of the variables, including the average impairment rating and the full scale WAIS IQ. However, significant group x trials interactions were not found for either the neuropsychological measures or the quality of life indices. The results did not support the conclusion of improved mental status or increased psychosocial well-being in patients who received carotid endarterectomies.

Depression in older people with mild stroke, carotid stenosis and peripheral vascular disease: a comparison with healthy controls

“…Kelly et al (1980) found no dierences between the two groups in depression scale scores using the Minnesota Multiphasic Personality Inventory. In a study of CE patients assessed pre-operatively by Parker et al (1983), no dierences were seen for`depressiondejection' using the Pro®le of Mood States scale, when compared with a control group of nonvascular surgical controls. One other study used a rating scale for depression with greater validity and reliability [Beck Depression Inventory (BDI)].…”

The Role of Carotid Stenosis in Vascular Cognitive Impairment

“…The possibility of both symptomatic and silent stroke occurring during the peri-operative period may also confound the relationship between stenosis and cognitive impairment [27, 28]. Studies using aspects of both verbal and performance IQ show conflicting results, with an improvement in performance IQ [7, 21]/verbal IQ [10], or neither [9, 13, 15, 18]. It is notable that three of the four studies employing the trailmaking tests show a post-operative improvement in performance [7, 12, 15].…”

“…Instead, studies have concentrated on examining the outcome of non-surgical interventions [13, 24]or vascular risk factors [10]. …”

“…Nevertheless, some degree of overlap exists in the instruments employed. Only one of six studies using the full Wechsler Adult Intelligence Scale (WAIS) to compare carotid stenosis patients with controls, notes greater impairment in both verbal/performance times of the WAIS in the carotid endarterectomy group [13]. Three do not make a statistical comparison.…”

Psychological impact of carotid endarterectomy: A review of the studies

“…Criteria of exclusion from the study concerned neurological deficit due to TIA or to recent stroke, asymptomatic condition, psychiatric symptoms, other neurological or cognitive pre-surgical deteriorations and stable physical disability [8,[11][12][13][14][15]. With respect to the study, almost all the studies used a repeated measure design with a first assessment before surgery.…”