Sustained cognitive benefit 5 years after carotid endarterectomy

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Abstract

Objectives: This study investigated the long-term effect of carotid endarterectomy (CEA) on cognitive brain function by means of P300 evoked potentials. Methods: Twenty-five consecutive patients (36% women) with a median age of 68 years underwent CEA with a median degree of stenosis of 90%. Cognitive brain function was objectively measured by means of P300 auditory evoked potentials (peak latencies in milliseconds [ms]) before CEA, at discharge, and at 1 and 5 years. Values were compared with 25 age-and sex-matched healthy individuals. Results: Cognitive P300 evoked potentials were prolonged (ie, impaired) in patients before CEA compared with controls (vertex [Cz], 384 ± 52 vs 357 ± 16 ms, P =.020]. At 1 year, P300 evoked potentials were significantly shortened (ie, improved) in patients after CEA compared with baseline values [Cz, 371 ± 38 vs 384 ± 52 ms, P =.010]. Furthermore, no difference between patients after CEA and controls was observed [Cz, 371 ± 38 vs 360 ± 14 ms, P =.21]. This effect was sustained at 5 years, and P300 evoked potentials continued to be significantly shortened (ie, improved) in patients after CEA compared with baseline values [Cz, 367 ± 39 vs 384 ± 52 ms, P =.040]. Continuing, no difference between patients after CEA and controls could be observed [Cz, 367 ± 39 vs 362 ± 17 ms, P =.58]. These results could be confirmed in repeated measures analysis of variance for Cz (P =.025) and frontal (Fz) results (P =.018). Conclusions: CEA improves previously impaired cognitive brain function as shown by P300 measurements similar to normal cognitive brain function of age-and sex-matched healthy individuals. This beneficial effect is sustained up to 5 years after treatment. Copyright © 2010 by the Society for Vascular Surgery.

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Czerny, M., Schuch, P., Sodeck, G., Bálassy, C., Hoelzenbein, T., Juraszek, A., … Grimm, M. (2010). Sustained cognitive benefit 5 years after carotid endarterectomy. Journal of Vascular Surgery, 51(5), 1139–1144. https://doi.org/10.1016/j.jvs.2009.11.072

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