Carotid Artery Stenting in Octogenarians: Results From the ALKK Carotid Artery Stent (CAS) Registry

Eur Heart J. 2007 Feb;28(3):370-5. doi: 10.1093/eurheartj/ehl421. Epub 2006 Dec 11.

Abstract

Aims: We tried to determine the influence of age on complication rates of carotid artery stenting (CAS).

Methods and results: Two thousand seven hundred eighty CAS procedures were included in the registry. Median age of the patients was 70.8 years, with a proportion of octogenarians of 11.2% and a significant increase between 1996 (5.9%) and 2005 (13.7%; P for trend = 0.002). In octogenarians, a symptomatic stenosis was a more frequent indication for CAS (60.7% vs. 48%, P < 0.001), the CAS procedure was aborted more frequently (6.9% vs. 2.2%; P < 0.001) and the duration of intervention was longer (Median 45 vs. 40 min; P = 0.008). Increasing age was associated with a significant increase in the in-hospital death or stroke rate (P for trend: 0.001). In-hospital death or stroke rate was also higher in octogenarians compared with younger patients (5.5 vs. 3.2%; P = 0.032, OR = 1.79; 95%CI: 1.04-3.06). Logistic regression analysis showed that age analysed as a continuous variable was a strong predictor of in-hospital death or stroke (P < 0.001), whereas octogenarians had only a trend towards a higher event rate (P = 0.062).

Conclusion: CAS in octogenarians is performed in an increasing proportion of patients. In-hospital stroke or death rates increase significantly with older age; however, there was no excess complication rate in octogenarians.

Publication types

  • Multicenter Study

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Coronary Stenosis / pathology
  • Coronary Stenosis / surgery*
  • Female
  • Hematologic Agents / therapeutic use
  • Hospital Mortality
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Middle Aged
  • Registries
  • Stents / adverse effects*
  • Stroke / etiology

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Hematologic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors