Changes in Health-related Quality of Life After Carotid Stenosis Treatment. Summary of the Doctoral Thesis

Abstract

Carotid artery stenosis is well-known causal risk factor for ischaemic stroke. Approximately 10–15% of all strokes follow thromboembolism from previously asymptomatic > 50% internal carotid stenosis. In addition to functional disability, stroke patients frequently go on to develop cognitive impairment and depression. In the last decade there is growing interest of “nonclassical” neurological symptoms caused by severe carotid stenosis and it’s associaton with the health-related quality of life and whether carotid interventions improve the development of these symptoms. The doctoral thesis “Changes in Health-Related Quality of Life after Carotid Stenosis Treatment” is devoted to investigation of global cognitive function, depressive symptoms and health-related quality of life because the goal of contemporary carotid stenosis management is not only to reduce stroke risk and to extend life expectancy but also to ensure a sufficient high long-term health-related quality of life. The aim of this study was to assess long-term changes in cognitive function, depressive symptoms and health-related quality of life after carotid stenosis revascularisation and the best medical treatment. Study involved 213 patients with severe carotid stenosis who underwent assessment of cognitive function, depressive symptoms and health-related quality of life. The assessment was performed before and at 6 and 12 months follow-up periods in patients who had carotid endarterectomy, carotid artery stenting or received the best medical treatment only. The research results show that revascularisation of severe carotid stenosis may be associated with improvement of global cognitive function. Whereas there was no significant change of depressive symptoms neither after revascularisation, nor after the best medical treatment. In general, carotid endarterectomy maintain preoperative health-related quality of life for at least one year. However, the evaluation of change in health-related quality of life in the carotid stenting and the best medical treatment group was influenced by several clinical parameters. Therefore, conclusive statements were not made at the moment.