The Hazards of Carotid Artery Stenting in Older Patients

In a meta-analysis of four randomized trials, stenting had a periprocedural stroke-or-death rate of 12%, far higher than the rate with endarterectomy in this age group.

Carotid revascularization procedures, including carotid endarterectomy (CEA) and carotid artery stenting (CAS), are the most frequently performed operations to prevent stroke; approximately 100,000 procedures are performed annually in the U.S. Whether certain patient subsets might do as well with CAS as with CEA, or conversely for whom CAS is more risky than CEA, are open questions. To explore the effect of age on the short-term and long-term risks of CEA and CAS, the Carotid Stenosis Trialists' Collaboration analyzed data from 4754 patients with symptomatic carotid stenosis from four clinical trials. For short-term risks, defined as within 120 days after study entry, CAS was associated with a nonsignificantly higher periprocedural complica…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

The Hazards of Carotid Artery Stenting in Older Patients

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Reviewing Author