title: Treatment of intractable angina in a nonagenarian patient by direct coronary stenting.
abstract: BACKGROUND
  A 91-year-old man presented with a 6-month history of exertional angina. As he was already on maximally tolerated medical therapy, we decided to perform coronary angiography, which revealed severe stenosis of the distal main stem coronary artery,
  
  
  RESULTS
  The lesion was crossed with an intra-coronary wire, and a stent placed 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.
  
  
  CONCLUSIONS
  Treatment of left main stem lesions with percutaneous intervention may be an acceptable alternative to surgery in high-risk elderly patients. Since percutaneous coronary angioplasty can be performed on very elderly patients with a high degree of success, the decision to investigate and treat should not be based solely on biological age.
authors.affiliation: Department of Cardiology, King's College Hospital, Bessemer Road, London SE5 9RS, UK. jonathan.byrne@kcl.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Byrne
authors.forename: J M
authors.initials: JM
authors.lastname: Cotton
authors.forename: R J
authors.initials: RJ
authors.lastname: Wainwright
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D015607:Stents