Carotid stenting in patients older than 65 years with inoperable carotid artery disease: A single-center experience

Carotid angioplasty and stenting to treat extracranial carotid stenosis is an alternative las yet not widely accepted) to high-risk surgery, but its s afety and efficacy are little known, especially in elderly patients. We rev iewed our 3-year experience of treating 100 elderly patients (> 65 years ol d) 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 ha d concomitant coronary artery disease (severe in 30 [defined by > 70% steno sis in two or more epicardial coronary arteries or the left main coronary a rtery]) and 25 had severe left ventricular dysfunction (ejection fraction l ess than or equal to 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 2 4 hr. (C) 2000 Wiley-Liss, Inc.