Carotid artery stenting in elderly patients: importance of case selection

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
Paul T L ChiamJ J Vitek

Abstract

This study was conducted to determine if carotid stenting (CS) could be safely performed in the elderly. Age has been shown to be a predictor of neurological complications during CS. We postulated that CS could be safely performed in elderly patients if certain anatomical and clinical markers such as excessive vascular tortuosity, heavy concentric calcification of the lesion, and decreased cerebral reserve were avoided. From July 2003 to October 2007, 142 patients aged > or =50% or asymptomatic stenosis > or =70%. All patients underwent carotid and cerebral angiography to determine anatomic suitability and stent risk. Demographic and outcome data were entered into a database; other data were obtained retrospectively. Independent neurology evaluation was performed before and at 24 hr after the procedure. The mean age was 83.2 years, 62% were male, 25.5% were symptomatic, 8.5% had postcarotid endarterectomy restenosis, and 6.0% had contralateral internal carotid artery occlusion. There were no intracranial hemorrhages or periprocedural myocardial infarctions. One patient had amaurosis fugax. There were two minor and three major strokes in-hospital (3.3%). All patients had 30-day follow-up. One of the major strokes expired. Thus t...Continue Reading

References

Nov 1, 1992·Stroke; a Journal of Cerebral Circulation·P A WolfW B Kannel
Aug 15, 1991·The New England Journal of Medicine·UNKNOWN North American Symptomatic Carotid Endarterectomy Trial CollaboratorsM Eliasziw
Dec 16, 1995·Lancet·P Rothwell, C Warlow
Feb 1, 1996·Stroke; a Journal of Cerebral Circulation·P M RothwellC P Warlow
May 7, 1998·Circulation·A MathurJ J Vitek
Jun 10, 1998·Journal of Vascular Surgery·P J O'HaraT M Sullivan
May 19, 2000·Annals of Surgery·J G MaxwellE Tinsley
Sep 21, 2000·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·A C TingY N Hsiang
Apr 27, 2001·Lancet·S AlamowitchUNKNOWN North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group
Oct 18, 2001·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·A OmmerW Sandmann
Sep 27, 2003·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·O AlozairiJ Brittenden
May 12, 2004·Lancet·A HallidayUNKNOWN MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group
Oct 8, 2004·The New England Journal of Medicine·Jay S YadavUNKNOWN Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy Investigators
Apr 26, 2005·Journal of the American College of Surgeons·Desarom TesoAlan Dardik
Oct 4, 2005·Annals of Vascular Surgery·Stephanie C LinPeter L Faries
Oct 4, 2005·Annals of Vascular Surgery·G Matthew LongoMark K Eskandari
Oct 18, 2005·American Journal of Surgery·David LauAgelikie Vouyouka
Feb 16, 2006·Journal of Vascular Surgery·Stephen F StanzialeMark H Wholey
Jun 20, 2006·Journal of the American College of Cardiology·Robert D SafianUNKNOWN CREATE Pivotal Trial Investigators
Jun 21, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Carlo SetacciAlberto Cremonesi
Sep 23, 2006·Stroke; a Journal of Cerebral Circulation·Robert HofmannKurt Huber
Dec 13, 2006·European Heart Journal·Ralf ZahnUNKNOWN Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte
Dec 16, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·William A GrayRichard Green

❮ Previous
Next ❯

Citations

Oct 21, 2010·Current Neurology and Neuroscience Reports·Adrian Marchidann, Randolph S Marshall
Sep 18, 2010·Current Treatment Options in Neurology·Kevin M Barrett, Thomas G Brott
May 22, 2010·JACC. Cardiovascular Interventions·Christopher J White
May 28, 2010·The New England Journal of Medicine·Thomas G BrottUNKNOWN CREST Investigators
Oct 13, 2010·Stroke; a Journal of Cerebral Circulation·Vito A ManteseUNKNOWN CREST Investigators
Oct 8, 2011·Stroke; a Journal of Cerebral Circulation·Jenifer H VoeksUNKNOWN CREST Investigators
Jun 15, 2010·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·L Nelson HopkinsDominic J Allocco
Jul 5, 2011·Progress in Cardiovascular Diseases·Robert D Safian
Jan 21, 2011·The American Journal of Emergency Medicine·Haralabos ZacharatosAdnan I Qureshi
Mar 2, 2010·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·L Nelson HopkinsThomas G Brott
Oct 10, 2009·Cardiovascular Revascularization Medicine : Including Molecular Interventions·George S ChrysantGeorgianne M Snowden
May 6, 2009·Circulation·Michael Belkin, Deepak L Bhatt
Nov 28, 2012·Circulation·Donald E Cutlip, Duane S Pinto
Sep 10, 2015·Stroke; a Journal of Cerebral Circulation·Jenifer H VoeksThomas G Brott
Jul 16, 2015·Stroke; a Journal of Cerebral Circulation·George HowardThomas G Brott
Mar 12, 2016·International Anesthesiology Clinics·Uoo R Kim, Rae M Allain
Jun 13, 2017·Frontiers in Neurology·Sung Hyuk Heo, Cheryl D Bushnell
Apr 24, 2019·Journal of Vascular Surgery·Besma NejimMahmoud B Malas

❮ Previous
Next ❯

Related Concepts

Related Feeds

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.