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Updated: Dec 27, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Thirty-Day Outcome of Carotid Artery Stenting in Elderly Patients: A Single-Center Experience
Yao Feng1, Xuesong Bai1, Shenmao Li1
1Interventional Radiology Diagnosis and Treatment Center, Department of Neurosurgery, Capital Medical University, Beijing, China.
Insights
Carotid artery stenting (CAS) is safe for elderly patients. Key risk factors for major adverse clinical events (MACE) after CAS include a family history of stroke, symptomatic status, and higher modified Rankin Scale scores.
Area of Science:
- Cardiovascular Surgery
- Interventional Neurology
- Geriatric Medicine
Background:
- The safety and efficacy of carotid artery stenting (CAS) in elderly populations remain a subject of ongoing clinical debate.
- Elderly patients represent a unique demographic with potentially higher risks following invasive vascular procedures.
Purpose of the Study:
- To assess the 30-day safety outcomes of CAS specifically in patients aged 70 years and older.
- To identify independent risk factors associated with major adverse clinical events (MACE) post-CAS in this elderly cohort.
- To provide evidence-based insights for enhancing CAS safety in older individuals.
Main Methods:
- Retrospective analysis of 1029 elderly patients (≥70 years) who underwent CAS between 2001 and 2017.
- Primary outcome: 30-day incidence of MACE, defined as death, myocardial infarction, or ipsilateral stroke.
- Statistical analysis included univariate and multivariate logistic regression to determine predictors of MACE.
Main Results:
- The overall incidence of 30-day MACE was 3.01% (31 cases), comprising deaths, strokes, and myocardial infarctions.
- Multivariate analysis identified independent predictors of MACE: family history of stroke (OR=3.817), symptomatic status (OR=2.650), and modified Rankin Scale score ≥3 (OR=4.594).
- Hyperlipidemia was not found to be an independent risk factor for MACE in this cohort.
Conclusions:
- Carotid artery stenting can be performed safely in elderly patients.
- Pre-existing conditions such as a family history of stroke, presenting with stroke symptoms, and significant pre-procedure neurological deficits (mRS ≥3) are associated with increased risk of postoperative MACE.
Background:
The safety of carotid artery stenting (CAS) in elderly patients is controversial. The aims of this study were to evaluate 30-day outcomes after CAS in elderly patients (≥70 years old) and to investigate risk factors for postoperative incidence of major adverse clinical events (MACE) to improve CAS safety based on clinical evidence in this specific subgroup of patients.
Methods:
The data set included patients who underwent CAS between 2001 and 2017 at Xuanwu Hospital, Capital Medical University. The primary outcome variable was 30-day postoperative incidence of the following MACE: death, myocardial infarction, and ipsilateral stroke. Univariate and multivariate analyses were performed to identify high-risk patients and procedural characteristics associated with MACE.
Results:
A total of 1029 elderly patients who underwent CAS for carotid artery stenosis were identified and analyzed. The incidence of postoperative MACE was 3.01% (n = 31 cases [5 deaths, 24 strokes, and 2 myocardial infarctions]). After multivariate analysis, independent predictors of MACE included a family history of stroke (odds ratio [OR] = 3.817; 95% confidence interval [CI], 1.227-11.876; P = 0.021), symptomatic status (OR = 2.650; 95% CI, 1.210-5.806; P = 0.015), and modified Rankin Scale score ≥3 (OR = 4.594; 95% CI, 1.708-12.352; P = 0.003). Hyperlipidemia was not an independent risk factor (OR = 1.597; 95% CI, 0.745-3.425; P = 0.229).
Conclusions:
At our center, CAS was safely performed in elderly patients. A family history of stroke, symptomatic status, and modified Rankin Scale score ≥3 indicating a neurologic deficit increased the risk of 30-day postoperative MACE.
