Outcomes of carotid artery stenting in patients aged 80 years or older with asymptomatic carotid artery stenosis.

Abstract

The outcomes of carotid artery stenting (CAS) for asymptomatic patients aged ≥80 years remain unclear. This study aimed to investigate the procedural and functional outcomes of CAS in these patients. This was a post-hoc analysis of a nationwide retrospective registry of patients with asymptomatic carotid artery stenosis who underwent CAS. The primary outcome was a composite of ischemic stroke and all-cause death. The secondary outcomes were ischemic stroke, all-cause death, acute occlusion, and acute myocardial infarction. Functional outcomes were assessed using the modified Rankin Scale (mRS). The outcomes were assessed 30 days post-procedure and compared between patients aged ≥80 years and <80 years. Overall, 4549 patients were evaluated. Pre-procedural mRS and the prevalence of ≥80% stenosis were higher in the ≥80-year-old group. Calcified lesions and high risk for carotid endarterectomy were more common in the ≥80-year-old group. No significant between-group differences were found in primary and secondary outcomes. However, the functional outcomes were significantly worse in the ≥80-year-old group, with a higher proportion of patients with worse mRS score (ie, decreasing at least one point) at follow-up (11.2% vs 5.0%; adjusted OR 2.24 (95% CI 1.66 to 3.02)). CAS for asymptomatic carotid artery stenosis is associated with poorer 30-day functional outcomes in patients aged ≥80 years than in those aged <80 years, but the composite of ischemic stroke and all-cause death is not significantly different between the two age groups.