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Carotid Artery Angioplasty and Stenting for Patients Less than 70 Years-of-Age

Published online by Cambridge University Press:  02 December 2014

Ryan Alkins ,
Charles C. Matouk ,
Juan P. Cruz ,
Thomas Marotta ,
Walter Montanera  and
Julian Spears
Ryan Alkins*
Affiliation:
Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
Charles C. Matouk
Affiliation:
Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada Neurovascular Program, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
Juan P. Cruz
Affiliation:
Neurovascular Program, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
Thomas Marotta
Affiliation:
Neurovascular Program, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
Walter Montanera
Affiliation:
Neurovascular Program, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
Julian Spears
Affiliation:
Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada Neurovascular Program, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
*
Division of Neurosurgery, St Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada. Email: ryan.alkins@utoronto.ca
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Abstract

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Background:

Recent studies have suggested that carotid artery angioplasty and stenting (CAS) is a safe alternative to carotid endarterectomy (CEA) in average risk patients <70 years of age. We examined a consecutive series of patients who underwent CAS in order to determine the influence of patient age on outcome.

Methods:

A retrospective, longitudinal cohort study of consecutive patients who underwent CAS at St. Michael's Hospital, Canada between January 2001 and November 2010 was performed. The outcome measures were 30-day stroke and 30-day composite death, stroke and acute myocardial infarction (MI). Patients were stratified based on age <70 and ≥70 years.

Results:

One hundred and fifty-nine patients underwent 165 CAS procedures. The 30-day risk of stroke was 3.8% while the composite outcome of death/stroke/MI was 8.2%. When stratified by age <70 and ≥70 years, the 30-day stroke rate was 0% versus 7.4% (p=0.03), and the composite outcome of death/stroke/MI was 2.6% versus 13.6% (p=0.02), respectively.

Conclusions:

Patients <70 years of age undergoing CAS have a low rate of major complications, comparing favourably with historical CEA adverse event rates, and supporting the recent carotid stenosis literature that in the younger population CAS has a similar complication rate compared to CEA.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 3 , May 2012 , pp. 338 - 342
Copyright
Copyright © The Canadian Journal of Neurological 2012

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