Unclogging carotid artery fails to improve cognition in clinical trial
Cognition often deteriorates when the brain's main blood vessels are clogged, but a Columbia-led study published in JAMA shows that cognition cannot be improved by opening the blockages with stenting or surgery.
This clinical trial, called CREST-H, found that procedures to unclog carotid arteries did not improve cognitive function in patients with severe blockages. Despite hopes based on animal studies and case series, a randomized clinical trial of 291 patients showed no difference in cognitive scores between those who underwent stenting or surgery and those who received medication alone.
Both groups showed slight improvements in cognition over a one-year period, but revascularization provided no additional cognitive benefit. The study's leader, Dr. Randolph Marshall, emphasizes the importance of preventing carotid stenosis to avoid its consequences.
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