title: Intracranial angioplasty and/or stent placement in octogenarians is associated with a threefold greater risk of periprocedural stroke or death.
abstract: OBJECTIVE
  To compare the clinical and angiographic outcomes of endovascular treatment of symptomatic intracranial stenosis between octogenarian and younger patients.
  
  
  METHODS
  Data for 244 consecutive patients (173 men; mean age 61.6 years) who underwent angioplasty and/or stenting for intracranial atherosclerotic disease at 5 specialized centers were pooled. Baseline, 30-day, and follow-up clinical and angiographic information were collected. Rates of clinical and angiographic endpoints were compared between patients >or=80 years old versus those <80 years.
  
  
  RESULTS
  Patients >or=80 years (n = 15) were more likely to be hypertensive (87% versus 69%) and have underlying coronary artery disease (73% versus 36%, p<0.05) compared to younger patients (n = 229). The rate of periprocedural stroke and/or death was 3-fold higher among patients aged >or=80 years compared with those <80 years (20% versus 7%, p = 0.11). No recurrent stroke or death (excluding periprocedural events) was observed during follow-up in the octogenarian group. In patients who had follow-up angiography, a similar rate of >or=50% restenosis was observed among patients aged >or=80 years and those aged <80 years (25% versus 29%, p>0.1).
  
  
  CONCLUSIONS
  The 3-fold higher periprocedural death and/or stroke rate suggests cautious use of intracranial angioplasty and/or stent placement in octogenarians.
authors.affiliation: The Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, Minnesota 55455, USA. fareedsuri@gmail.com
authors.forename: M Fareed K
authors.initials: MF
authors.lastname: Suri
authors.forename: Nauman
authors.initials: N
authors.lastname: Tariq
authors.forename: Farhan
authors.initials: F
authors.lastname: Siddiq
authors.forename: Gabriela
authors.initials: G
authors.lastname: Vazquez
authors.forename: Robert A
authors.initials: RA
authors.lastname: Taylor
authors.forename: Ramachandra P
authors.initials: RP
authors.lastname: Tummala
authors.forename: Joan C
authors.initials: JC
authors.lastname: Wojak
authors.forename: John C
authors.initials: JC
authors.lastname: Chaloupka
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects* / Q000295:instrumentation*; D002533:Cerebral Angiography; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D020521:Stroke / Q000209:etiology* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult