الفهرس 
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Abstract
Background: Symptomatic carotid stenosis is commonly defined as stenosis in the internal carotid artery, intracranial or extracranial, leading to symptoms of amaurosis fugax, transient ischemic attacks, or ischemic stroke ipsilateral to the lesion. Degree of stenosis varies among the major therapeutic trials studying treatment of carotid stenosis, but severe stenosis (70–99%) has been demonstrated to confer the highest risk for recurrent stroke or TIA. The number of people suffering from arteriosclerosis with vascular risk factors has been increas¬ing recently due to the westernization of diet patterns and changing living environments, which has led to the increase in the number of patients with carotid stenosis (CS) or cerebral infarction. Se¬vere CS is one of the important culprits underlying cerebral infarction, and can cause cognitive impairments due to continuous perfusion defects.
Aim: The aim of this study was to detect the effect of revascularization procedures on cognitive functions from baseline to 3 months follow up post-procedure in patients with CS using comprehensive psychometric tests.
Methodology: A prospective nonrandomized hospital based study was done at Ain Shams University hospitals. The study was conducted over 3 years from January 2015 till March 2018. Eighty patients with CS were enrolled, 34 patients underwent CAS procedure, six patients underwent CEA using standard techniques and the other 40 control patients follow up on conservative medical treatment. Decisions about whether and which method of treatment was applied (CEA, CAS, conservative) were taken independently of the study and were up to the treating physicians and patients. All CEAs and stents were performed under local anesthesia; periprocedural embolization was detected using follow up DW MRI imaging.
Results: Comparisons of clinical information at baseline between two groups On the basis of inclusion and exclusion criteria, a total of 80 patients were recruited into the present study and received regular follow-up. 2 were lost to follow-up from the control group (died after 2 months of study). The main determinants (age, males/ females ratio, education level, DM, HTN, dyslipidemia, ISHD, smoking, laterality and degree of stenosis by CD and DSA) were compared between patients of the two groups to make sure that both groups were homogenous with no selection bias. There was no significant difference between the two groups except for the age, total number of previous strokes as well as presence of contralateral stenosis which were more prevalent in the intervention group (p<0.05) and thus may affect their cognitive results.
Conclusion: that extracranial carotid intervention either CAS or CEA exerts benefi-cial effects on some of the cognitive functions of symptomatic CS patients at 3 months after treatment, in particular, the visual, working memory and executive functions.
Recommendations: Early detection of carotid artery stenosis in clinically suspected patients by routine checkup with duplex ultrasound.