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Published online before print June 14, 2006, 10.1148/radiol.2402051043
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(Radiology 2006;240:508-514.)
© RSNA, 2006

Neuroradiology

Is There Improvement of "Vascular Depression" after Carotid Artery Stent Placement?1

Wolfgang Mlekusch, MD, Irene Mlekusch, PhD, Erich Minar, MD, Markus Haumer, MD, Christoph W. Kopp, MD, Ramazanali Ahmadi, MD, Johannes Lehrner, PhD and Martin Schillinger, MD

1 From the Department of Internal Medicine II, Departments of Angiology (W.M., I.M., E.M., M.H., C.W.K., R.A., M.S.) and Neurology (J.L.), Vienna General Hospital, Medical School, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Received June 21, 2005; revision requested August 18; revision received August 29; accepted September 21; final version accepted September 28. Address correspondence to W.M. (e-mail: wolfgang.mlekusch{at}meduniwien.ac.at).

Purpose: To prospectively evaluate if high-grade (≥80% luminal narrowing) internal carotid artery stenosis is associated with depressive symptoms and if carotid artery stent placement (CAS) potentially improves depressive symptoms.

Materials and Methods: The study was approved by the local ethics committee, and informed consent was obtained from all subjects. One hundred forty-three patients (91 men, 52 women; interquartile range, 63–76 years) undergoing CAS because of asymptomatic high-grade (≥80% luminal narrowing) carotid artery stenosis and 102 control subjects (64 men, 38 women; interquartile range, 63–73 years) with advanced peripheral artery disease and without carotid artery stenosis undergoing lower-limb percutaneous transluminal angioplasty were included. Substantial depressive symptoms (defined as a Beck Depression Inventory score of 10 or higher) were recorded at baseline and at 4 weeks (follow-up) after the percutaneous procedures. The {chi}2 test, Mann-Whitney U test, McNemar test, Wilcoxon rank sum test, and two-group t test were used to check for statistical significance.

Results: A significantly higher prevalence of depressive symptoms was found in patients with carotid artery stenosis than in control subjects with peripheral artery disease at baseline (33.6% vs 16.7%, P = .003). At follow-up, a significant reduction of depressive symptoms was found in patients who underwent CAS (33.6% vs 9.8%, P < .001). The frequency of depressive symptoms remained unaffected in control subjects (16.7% vs 13.0%, P = .1).

Conclusion: High-grade carotid artery stenosis is associated with depressive symptoms in patients with atherosclerosis. CAS seems to exert beneficial effects on the course of depressive symptoms in these patients.

© RSNA, 2006




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