Does Revascularization Affect Cognition in Patients with Otherwise Asymptomatic Carotid Stenosis?

“Asymptomatic carotid stenosis” refers to carotid stenosis in patients with no history of stroke or transient ischemic attack. However, observational studies have suggested that otherwise asymptomatic stenosis might cause cognitive deficits in some patients. If that’s true, could revascularization stabilize or reverse that process?

To explore this question, researchers performed a secondary analysis within the landmark CREST-2 randomized trial, in which 2500 patients with asymptomatic carotid stenosis of ≥70% received intensive medical management alone or intensive medical management plus revascularization (with endarterectomy or stenting). Patients underwent standardized 25-minute cognitive assessments (administered by telephone) ann…