title: Unprotected carotid artery stenting in symptomatic elderly patients: a single-center experience.
abstract: OBJECTIVE
  Surgery is known to have fewer adverse events in patients aged >75 years with carotid stenosis, but some are not candidates due to comorbidity. Stenting using protection devices is the most accepted endovascular technique. Our aim is to show the safety and efficacy of carotid stenting without any protection device in these patients.
  
  
  METHODS
  All patients older than 75 years with carotid stenosis treated in our center between January 2002 and December 2012 were included in this prospective study. All were treated by carotid stenting without protection devices. Angiographic results, neurologic complications and Doppler ultrasound were collected during the procedure and within 30 days.
  
  
  RESULTS
  49 patients were included (mean age 78.2 years, range 75-86). The average degree of stenosis was 88.2%. During the procedure there were two cases of transient ischemic attack and one intraparenchymal hemorrhage. At 30 days there was a non-disabling stroke. The combined rate of disabling stroke plus myocardial infarction plus death was 6% at 30 days and the rate of any stroke was 4% during the procedure and 2% at 30 days.
  
  
  CONCLUSIONS
  Endovascular treatment of carotid stenosis without protection devices in symptomatic patients aged >75 years is an alternative to endovascular treatment with protection devices. Complications and mortality rates are similar to studies that used protection devices in lower risk patients.
authors.affiliation: Neuroradiology Unit, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Elvira
authors.initials: E
authors.lastname: Jimenez-Gomez
authors.affiliation: Neuroradiology Unit, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Antonio Cano
authors.initials: AC
authors.lastname: Sánchez
authors.affiliation: Neuroradiology Unit, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Rafael Oteros
authors.initials: RO
authors.lastname: Fernández
authors.affiliation: Neurology Unit, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Saray Valenzuela
authors.initials: SV
authors.lastname: Alvarado
authors.affiliation: Neuroradiology Unit, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Bravo-Rodriguez
authors.affiliation: Neuroradiology Unit, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Fernando Delgado
authors.initials: FD
authors.lastname: Acosta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D015607:Stents / Q000009:adverse effects
keywords: Angioplasty; Atherosclerosis; Stent