Periprocedural Outcomes of Carotid Artery Stenting in Elderly Patients
Masataka Nanto1, Yudai Goto2, Hiroyuki Yamamoto2
1Department of Neurosurgery, Kyoto Second Red Cross Hospital, Kyoto, Japan.
Insights
Carotid artery stenting is a safe procedure for elderly patients (≥80 years old), showing comparable outcomes to younger patients. While minor strokes were more frequent in older individuals, major stroke rates remained similar, indicating safety for this demographic.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Geriatric Medicine
Background:
- Carotid artery stenting (CAS) offers an alternative to carotid endarterectomy (CEA), particularly for high-risk patients.
- Advanced age (≥80 years) is a known risk factor for CEA, but its impact on CAS outcomes requires further evaluation.
- Previous reports suggest a potential association between older age and increased adverse events following CAS.
Purpose of the Study:
- To investigate the association between patient age and periprocedural outcomes after carotid artery stenting.
- To compare the safety and efficacy of CAS in elderly patients (≥80 years) versus non-elderly patients (<80 years).
Main Methods:
- A retrospective analysis of 126 patients undergoing CAS for symptomatic or asymptomatic carotid artery stenosis.
- Patients were stratified into two groups: elderly (≥80 years) and non-elderly (<80 years).
- Tailored CAS techniques, including stent type and embolic protection devices, were used based on patient characteristics. Outcomes were assessed periprocedurally and clinically.
Main Results:
- No significant differences in periprocedural neurologic complications (P=.095) or major stroke (P=1) between elderly and non-elderly groups.
- Minor stroke occurred more frequently in the elderly group (P=.021).
- New ischemic lesions on postprocedural imaging and rates of myocardial infarction and death were similar between groups.
Conclusions:
- Carotid artery stenting is a safe and effective treatment option for elderly patients (≥80 years).
- Outcomes in elderly patients are comparable to those in non-elderly patients undergoing CAS.
- The procedure demonstrates a favorable safety profile across different age groups.
Background:
Carotid artery stenting has emerged as an alternative to carotid endarterectomy especially in patients with high risk of carotid endarterectomy. Older age (≥80 years old) was recognized as one of the high risk factors of carotid endarterectomy. However, the association between older age and increased risk of adverse events for carotid artery stenting has been reported. The purpose of this study was to evaluate the association between age and periprocedural outcomes after carotid artery stenting.
Methods:
A total of 126 symptomatic and asymptomatic cases of carotid artery stenosis were treated with tailored carotid artery stenting. The type of stents and embolic protection devices were chosen according to clinical and morphologic characteristics of the patients. Procedural, imaging, and clinical outcomes were retrospectively assessed and compared between the elderly patients group (≥80 years old) and the non-elderly patients group (<80 years old).
Results:
Clinical and morphologic characteristics except for dyslipidemia were not significantly different between the 2 groups. Periprocedural neurologic complications were not significantly different between the 2 groups (P = .095). Minor stroke occurred more frequently in the elderly patients group (P = .021). However, the frequency of major stroke was not significantly different between the 2 groups (P = 1). Presence of new ischemic lesions on postprocedural examination was not significantly different between the 2 groups (P = .84). Myocardial infarction and death did not occur in either group.
Conclusions:
Carotid artery stenting can be performed safely in elderly patients, comparable with non-elderly patients.
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