Carotid artery stenting in older patients: is age a risk factor for poor outcome?

Purpose: To assess the impact of age on technical success and complications of carotid stenting in a prospective single-center cohort study.

Methods: One hundred eleven consecutive patients (74 men; median age 70 years) with >or=70% symptomatic (n=33) or >or=90% asymptomatic (n=78) internal carotid artery (ICA) stenosis underwent carotid artery stent implantation. Primary technical success and periprocedural complications were compared in patients aged >75 years (n=28) to patients <75 years (n=83).

Results: Patient groups below and above 75 years compared well with respect to baseline demographic and clinical data. Successful stenting was achieved in 108 (97%) patients. The combined neurological complication rate was 7% (n=8), with 1 (1%) major stroke, 1 (1%) minor stroke, and no 30-day mortality. Technical angiographic complications occurred in 8 (7%) patients. No significant differences between patients >75 years and those <75 years were observed for primary success rates (100% [28/28] versus 96% [80/83]; p=0.8), overall complications (14% [4/28] versus 16% [13/83]; p=1.0), neurological complications (7% [2/28] versus 7% [6/83]; p=1.0), or technical complications (7% [2/28] versus 4% [3/83]; p=0.6).

Conclusions: Elective carotid stenting can be performed safely in older patients with several comorbidities. Patient age does not seem to be an independent risk factor for poor outcome after endovascular treatment of internal carotid artery stenosis.