Characteristics and outcomes of elderly patients undergoing carotid stenting: Experience of a high-volume interventional cardiology center.

Abstract

Carotid artery stenting (CAS) is an attractive option in order to treat carotid artery stenosis. However, its safety in elderly patients is questioned. Aim of this single-center retrospective study was to assess data of elderly patients undergoing CAS, and to compare them with those of the younger (< 75 years). We collected data of 580 consecutive patients undergoing CAS between December 2007 and June 2020 and compared clinical and procedural characteristics as well as in-hospital major adverse events (MACCE) and long-term mortality between patients < 75 years and patients ≥ 75 years old. There were 272 patients (46.9%) with age ≥ 75 years and 308 patients (53.1%) with age < 75 years. The median follow-up was 48 months (range 2-144). There was no significant difference about in-hospital MACCE between the two groups (4.7% in the older vs. 3.5% in the younger group, p=0.9), but a higher rate of cerebral hemorrhage occurred in the older group (1.8% vs. = 0.3%, p=0.07), even if not significant. Long-term mortality was significantly higher in the older group (27.9 vs. 20.1%, p=0.027). Multivariate predictors of 12-months mortality were neurologic symptoms within 6months (OR: 4.83; 95% CI: 2.04-11.42; p ≤ 0.001), smoking status (OR: 2.84; 95% CI: 1.17-6.86; p=0.02) and age ≥ 75 years (OR: 2.78; 95% CI: 1.14-6.76; p=0.024). In elderly patients, CAS can be carried out efficaciously with acceptable procedural risks, if performed by expert operators and after a correct selection by a multidisciplinary team.