Journal article
Carotid angioplasty and stenting in the elderly
Neuroradiology, Vol.49(11), pp.933-938
11/2007
DOI: 10.1007/s00234-007-0278-1
PMID: 17657482
Abstract
To investigate the technical success rate as well as the procedural and mid-term complication rates of carotid angioplasty and stenting in elderly patients, a group excluded from large randomized endarterectomy trials given their perceived high surgical risk.Of 200 consecutive carotid angioplasty and/or stenting procedures performed between March 1996 and March 2005, 21 procedures were performed without cerebral protection devices in 20 patients over the age of 79 years (mean age: 83 years, 12 men, eight women). These patients’ medical records were retrospectively reviewed for vascular imaging reports and available clinical follow-up. Procedural and mid-term complication rates were calculated and compared to a previously published cohort of 133 consecutive patients ≤79 years of age who also underwent endovascular treatment at our institution.Carotid stenosis was reduced from a mean of 82% to no significant stenosis in all procedures. The procedural stroke rate was zero of 21 procedures. The procedural transient ischemic attack rate (TIA) was one of 21 procedures (4.8%). Mean follow-up was 24.6 months (range: 1.0–79.5 months) with at least a 30-day follow-up for 20 of the 21 procedures (95.2%). There were no new strokes. There was one recurrent ipsilateral TIA at 1.9 months. In five cases with follow-up carotid ultrasonography, no hemodynamically significant restenosis had occurred. There were three myocardial infarctions (MI) occurring at 0.5, 2.1, and 15.2 months, of which the last MI was fatal. The composite 30-day stroke and death rate was zero of 21 procedures (95% confidence interval: 0–14%). No significant difference was found in the 30-day rate of stroke, TIA, MI, or death between the elderly and younger patients.Carotid angioplasty and stenting in elderly patients can be performed successfully with acceptable procedural and mid-term complication rates comparable to younger patients.
Details
- Title: Subtitle
- Carotid angioplasty and stenting in the elderly
- Creators
- Yasha Kadkhodayan - Interventional Neuroradiology, Mallinckrodt Institute of Radiology Washington University School of Medicine 510 South Kingshighway Blvd St. Louis MO 63110 USADewitte Cross III - Department of Neurological Surgery Washington University School of Medicine St. Louis MO USAColin Derdeyn - Department of Neurology Washington University School of Medicine St. Louis MO USAChristopher Moran - Department of Neurological Surgery Washington University School of Medicine St. Louis MO USA
- Resource Type
- Journal article
- Publication Details
- Neuroradiology, Vol.49(11), pp.933-938
- Publisher
- Springer-Verlag; Berlin/Heidelberg
- DOI
- 10.1007/s00234-007-0278-1
- PMID
- 17657482
- ISSN
- 0028-3940
- eISSN
- 1432-1920
- Language
- English
- Date published
- 11/2007
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984013111902771
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