Objectives: To evaluate the risk factors and safety of carotid angioplasty and stenting(CAS) for extracranial carotid stenosis in elderly patients and summarize CAS on the indication of elderly patients and the prevention of complications.
Methods: The population characteristics, clinical features and vascular data of 60 elderly patients (≥ 75 years) treated between June 2001 and December 2010 were retrospectively analyzed. There were 57 male and 3 female. The median age of the patients was 78.8 years (range, 75 - 93 years ). The mean case history was 2.5 months with a range of 1 to 6 months. To summarize the prognosis of CAS according to the reduction of stenosis, NIHSS score, the incidence of early postoperative, 30 days adverse events and the follow-up status. Using χ(2) test as the statistical method.
Results: The mean stenosis was reduced from 81% ± 17% preoperative to 18% ± 9% postoperative. NIHSS score was reduced from preoperative 22 ± 8 to postoperative 10 ± 4. The average follow-up period was 1.5 years (range from 3 months to 3 years), and the results showed no procedure-related death occurred. Ipsilateral stroke occurred in 1 case (1.7%) and restenosis (≥ 50%) occurred in 2 patients (3.3%). Diabetes (χ(2) = 23.96, P < 0.01)and cardiac insufficiency (χ(2) = 6.446, P < 0.05)had a respectively significant impact on the incidence of early postoperative complications.
Conclusions: CAS can be effective in restoring carotid artery stenosis of elderly patients and preventing the occurrence of stroke. The elderly, diabetes, cardiac insufficiency are more likely to increase the postoperative risk of adverse events.