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Carotid Endarterectomy (CEA) is a surgical treatment validated to prevent cerebral ischemia, embolism and stroke in patients affected by severe stenosis of the carotid artery. A 1999 systematic review of the literature found controversial results about CEA influence on improvement of post-surgical cognitive performance. Moreover, few studies addressed the issue of the positive effects of CEA on quality of life and depression, reporting also controversial findings. The present review was aimed at considering the last 20 years studies focusing on the effects of CEA on the psychological dimensions. The purpose was to clarify the benefits, in terms of psychological well-being, offered by CEA, besides a reduction of the cardiovascular risk, as well as to have indication to lead further research in this area. Results of the 39 studies considered suggest that, although few studies show cognitive deterioration, most of them show stability with a tendency to improve both in cognitive functions and in other psychological areas. Further research is needed to clarify when it would be appropriate the use of CEA, the characteristics of eligible patients, and psychological as well as physical expected outcomes.

The aim of this study was to investigate changes in cognitive function following carotid endarterectomy (CEA). In 74 asymptomatic CEA patients cognitive function, depression, laterality and severity of stenosis, cerebral Computer Tomography results, and ischemic heart diseases were measured preoperatively. The sample included 31 patients with dementia and 43 patients without any symptom of dementia. Cognitive function was measured again at 3 months postoperatively using a brief standardised test. After controlling for cognitive function and depression at baseline, cognitive function improved significantly at 3 months after CEA in both patients with and without dementia. CEA may offer more than reduced stroke risk to patients, independent of cognitive function.