Treatment of intractable angina in a nonagenarian patient by direct coronary stenting

Background: a 91-year-old man presented,vith a 6-month history of exertiona l angina. As he was already on maximally tolerated medical therapy, we deci ded to perform coronary angiography, which revealed severe stenosis of the distal main stem coronary artery, Outcome: the lesion was crossed with an intra-coronary wire, and a stent pl aced to cover the distal main stem lesion, without prior balloon dilatation , The result was satisfactory and he remains symptom-free at 6-month follow -up. Conclusion: treatment of left main stem lesions with percutaneous intervent ion may be an acceptable alternative to surgery in high-risk elderly patien ts. Since percutaneous coronary angioplasty can be performed on very elderl y patients with a high degree of success, the decision to investigate and t reat should not be based solely on biological age.