Clinical significance of hemodynamic cerebral ischemia on cognitive function in carotid artery stenosis: a prospective study before and after revascularization.

Abstract Carotid stenosis is known to have negative impacts on cognitive function. However, it is still unclear through which mechanisms cognitive function is impaired in patients with carotid stenosis. This study was aimed to clarify the impact of cerebral hemodynamics on cognitive function in carotid stenosis. This prospective study included totally 109 patients with carotid stenosis who underwent carotid endarterectomy (CEA) or carotid artery stenting (CAS). Using N-isopropyl-p-[123I]-iodoamphetamine SPECT, cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) to acetazolamide were quantitatively measured in all patients before and after CEA/CAS. Based on preoperative data, the patients were categorized into three groups: Type 1 (CBF ≥32 mL/min/100 g, CVR ≥10%), Type 2 (CBF ≥32 mL/min/100 g and CVR