title: Carotid artery angioplasty and stenting for patients less than 70 years-of-age.
abstract: BACKGROUND
  Recent studies have suggested that carotid artery angioplasty and stenting (CAS) is a safe alternative to carotid endarterectomy (CEA) in average risk patients <70 years of age. We examined a consecutive series of patients who underwent CAS in order to determine the influence of patient age on outcome.
  
  
  METHODS
  A retrospective, longitudinal cohort study of consecutive patients who underwent CAS at St. Michael's Hospital, Canada between January 2001 and November 2010 was performed. The outcome measures were 30-day stroke and 30-day composite death, stroke and acute myocardial infarction (MI). Patients were stratified based on age <70 and ≥ 70 years.
  
  
  RESULTS
  One hundred and fifty-nine patients underwent 165 CAS procedures. The 30-day risk of stroke was 3.8% while the composite outcome of death/stroke/MI was 8.2%. When stratified by age <70 and ≥ 70 years, the 30-day stroke rate was 0% versus 7.4% (p=0.03), and the composite outcome of death/stroke/MI was 2.6% versus 13.6% (p=0.02), respectively.
  
  
  CONCLUSIONS
  Patients <70 years of age undergoing CAS have a low rate of major complications, comparing favourably with historical CEA adverse event rates, and supporting the recent carotid stenosis literature that in the younger population CAS has a similar complication rate compared to CEA.
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. ryan.alkins@utoronto.ca
authors.forename: Ryan
authors.initials: R
authors.lastname: Alkins
authors.forename: Charles C
authors.initials: CC
authors.lastname: Matouk
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cruz
authors.forename: Thomas
authors.initials: T
authors.lastname: Marotta
authors.forename: Walter
authors.initials: W
authors.lastname: Montanera
authors.forename: Julian
authors.initials: J
authors.lastname: Spears
mesh_terms: D000367:Age Factors; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects* / Q000379:methods; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents / Q000009:adverse effects*; D020521:Stroke / Q000209:etiology* / Q000401:mortality; D013997:Time Factors