Carotid Stents Evaluated in Octogenarians

Patients at high risk of carotid stenosis are candidates for carotid artery stenting. The Center for Medicare and Medicaid Services approved reimbursement for the procedure in 2005.

Aws Alawi, MD, a neurologist at St. Louis University Hospital, St. Louis, MO, and colleagues reported on a group of patients who were 80 years old when they had the procedure.

In an abstract due presented at a poster session April 21 at the 2015 annual meeting of the American Academy of Neurology in Washington, DC, the researchers said they looked at 1,818 CAS procedures performed in this age group.

They found the cases in the National Inpatient Sample database for the years 2001 through 2009.

The procedure was most often done in men and in patients who identified racially as white. The majority of the octogenarian patients were on Medicare.

Ninety-one percent of these 80-year-olds also had co-morbid high risk factors, compared to a rate of 83.2% in those under age 60.

The overall periprocedural outcome of stroke, myocardial infarction and death across all ages getting the procedure was 2.37%. It was only slightly higher (2.75%) in the 80-year-olds.

The findings were more encouraging than those in the CREST trial, the team said, referring to the Carotid Revascularization Endarterectomy vs. Stent Trial begun in 2000.

“A slight increase in periprocedural risk [of stroke and MI] is noted with age, though it appeared to plateau after age 70,” they reported.