Carotid artery stenting found to be safe in the elderly

Researchers at Thomas Jefferson University Hospital in Philadelphia and a multicenter team of investigators have found that carotid artery stenting (CAS) is safe and effective in patients age 70 and older.

Their research showed that while the instance of adverse events (stroke, heart attack, death) increases with age in this high-risk population, in comparison to historical data, the risk remains extremely low, at 6 percent, even in those ages 85 and up. Previous studies of elderly patients showed only a 7 percent risk of stroke, heart attack or death following carotid stent placement.

Nicholas J. Ruggiero, II, MD, F.A.C.C., F.S.C.A.I., F.S.V.M., director of Structural Heart Disease and Non-Coronary Interventions, Jefferson Heart Institute, assistant professor of Medicine, Jefferson Medical College and lead author on the study will present the findings at the American College of Cardiology annual meeting in Chicago on Monday, March 26.

Researchers retrospectively reviewed data on 5,005 high-risk patients undergoing CAS from the National Cardiovascular Data Registry (NCDR) CARE registry using patient demographics, provider and facility characteristics, the use of balloons, stents, and embolic protection devices, medications and neurological status, adverse event rates, and more.

The team stratified the patients into four age intervals: ages 70-74, 75-79, 80-84 and 85 and older. They found the rate of stroke, heart attack or death did not exceed 4.5 percent up to age 85. They did, however, observe an increasing rate of adverse neurologic events with age.

Ruggiero says the findings are significant and could impact patient care.

"As one of the largest series to look at the safety and effectiveness of CAS in older adults, we are encouraged that this potentially life-saving procedure can be safely extended to even our oldest patients."