Carotid stenting in patients older than 65 years with inoperable carotid artery disease: A single-center experience
✍ Scribed by Anjan Gupta; Atul Bhatia; Arvind Ahuja; Yoseph Shalev; Tanvir Bajwa
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 300 KB
- Volume
- 50
- Category
- Article
- ISSN
- 1522-1946
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✦ Synopsis
Carotid angioplasty and stenting to treat extracranial carotid stenosis is an alternative (as yet not widely accepted) to high-risk surgery, but its safety and efficacy are little known, especially in elderly patients. We reviewed our 3-year experience of treating 100 elderly patients (> 65 years old) considered to be inoperable (76 men, 24 women, mean age 76 ؎ 10 years, mean follow-up 18 ؎ 9.2 months) and present two case histories. Most (85%) were symptomatic (transient ischemic attacks in 60, stroke in 25); 80 had concomitant coronary artery disease (severe in 30 [defined by > 70% stenosis in two or more epicardial coronary arteries or the left main coronary artery]) and 25 had severe left ventricular dysfunction (ejection fraction ≤ 20%). The procedure was technically successful in all patients; there was one major stroke and no patient died. Postprocedure, 15% had minor complications: reversible neurological deficit (5%), pulmonary edema (3%), prolonged hypotension (3%), vascular access complications (3%), and neck hematoma (1%). Over 90% of patients were discharged home within 24 hr.