Carotid artery stenting in octogenarians: results from the ALKK Carotid Artery Stent (CAS) Registry.
OBJECTIVE
We tried to determine the influence of age on complication rates of carotid artery stenting (CAS).


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).


CONCLUSIONS
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.
Zahn
Ralf
R
Städtisches Klinikum, Med. Klinik 8, Kardiologie/Angiologie/Internistische Intensivmedizin, Klinikum Nürnberg, 90471 Nürnberg, Germany. erzahn@aol.com
Ischinger
Thomas
T
Hochadel
Matthias
M
Zeymer
Uwe
U
Schmalz
Wolfgang
W
Treese
Norbert
N
Hauptmann
Karl Eugen
KE
Seggewiss
Hubert
H
Janicke
Ilse
I
Haase
Hartwig
H
Mudra
Harald
H
Senges
Jochen
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D023921:Coronary Stenosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006401:Hematologic Agents / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012042:Registries; D015607:Stents / Q000009:adverse effects*; D020521:Stroke / Q000209:etiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D006401:Hematologic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors