Carotid artery stenting in octogenarians

Abstract

In an ageing population, stroke is a major cause of disability and the second leading cause of mortality in Western countries. The golden standard for treating carotid artery occlusive disease, even for patients aged 80 years and older, is still surgical endarterectomy. However, minimal invasive alternative treatments, like carotid artery stenting are very attractive for both the patient and the physician, but early reports dealing with carotid stenting in octogenarians were disappointing with a too high 30-day stroke and death rate. However, better patient selection and better knowledge and mapping of the vascular (supra-aortic) anatomy as well as an increased experience of the interventionalist in carotid artery stenting can result in a succesful clinical outcome after carotid artery stenting with short-and midterm results comparable with surgery.