Carotid endarterectomy and carotid artery stenting in advanced age patients

Pryamikov A.D.

Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital

ORCID: 0000-0002-4202-7549

Mironkov A.B.

Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital

ORCID: 0000-0003-0951-908X

Loluev R.Yu.

Pirogov Russian National Research Medical University

Khripun A.I.

Pirogov Russian National Research Medical University

ORCID: 0000-0001-7669-0835

Carotid endarterectomy and carotid artery stenting in advanced age patients

Authors:

Pryamikov A.D., Mironkov A.B., Loluev R.Yu., Khripun A.I.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2021;85(1): 113‑117

DOI: 10.17116/neiro202185011113

Downloaded: 176

To cite this article:

Pryamikov AD, Mironkov AB, Loluev RYu, Khripun AI. Carotid endarterectomy and carotid artery stenting in advanced age patients. Burdenko's Journal of Neurosurgery. 2021;85(1):113‑117. (In Russ., In Engl.)
https://doi.org/10.17116/neiro202185011113

Подписка 2025-2 (Burdenko's Journal of Neurosurgery)

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The manuscript is devoted to world experience of carotid endarterectomy and carotid artery stenting in advanced age patients. Some authors report the advantages of endovascular surgery in elderly patients while the others prefer carotid endarterectomy. Senile patients (75—80 years old) with asymptomatic internal carotid artery stenosis is one of the most difficult group for the management. This is due to a more complex assessment of perioperative surgical risk, high incidence of complicated atherosclerotic plaques in carotid arteries and dubious benefits of surgery considering short life expectancy and severe comorbidities. Accumulation of experience in the management of advanced age patients should be valuable for either optimizing or individualizing surgical strategy.

Keywords:

carotid endarterectomy

carotid artery stenting

elderly patient

Authors:

Pryamikov A.D.

Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital

ORCID: 0000-0002-4202-7549

Mironkov A.B.

Pirogov Russian National Research Medical University;
Buyanov Moscow City Clinical Hospital

ORCID: 0000-0003-0951-908X

Loluev R.Yu.

Pirogov Russian National Research Medical University

Khripun A.I.

Pirogov Russian National Research Medical University

ORCID: 0000-0001-7669-0835

Received:

27.04.2019

Accepted:

02.11.2020

List of references:

Ballotta E, Toniato A, Da Roit A, Lorenzetti R, Piatto G, Baracchini C. Carotid endarterectomy for asymptomatic carotid stenosis in very elderly. Journal of Vascular Surgery. 2015;61(2):2:382-388. https://doi.org/10.1016/j.jvs.2014.07.090
Grufman H, Schiopu A, Edsfeldt A, Bjorkbacka H, Nitulescu M, Nilsson M, Persson A, Nilsson J, Goncalves I. Evidence for altered inflammatory and repair responses in symptomatic carotid plaques from elderly patients. Atherosclerosis. 2014;237(1):177-182. https://doi.org/10.1016/j.atherosclerosis.2014.08.042
Heo SH, Bushnell CD. Factors influencing decision making for carotid endarterectomy versus stenting in the very elderly. Frontiers in Neurology. 2017;26(8):220. https://doi.org/10.3389/fneur.2017.00220
Halandras PM. Vascular surgery and geriatric patients. Clinics in Geriatric Medicine. 2019;35(1):93-101. https://doi.org/10.1016/j.cger.2018.08.008
Leifheit EC, Wang Y, Howard G, Goldstein LB, Brott TG, Lichtman JH. Outcomes after carotid endarterectomy among elderly dual Medicare-Medicaid-eligible patients. Neurology. 2018;91(17):1553-1558. https://doi.org/10.1012/WNL.0000000000006380
de Weerd M, Greving JP, Hedblad B, Lorenz MW, Mathiesen EB, O’Leary DH, Rosvall M, Sitzer M, Buskens E, Bots ML. Prevalence of asymptomatic carotid artery stenosis in general population: an individual participant data meta-analysis. Stroke. 2010;41(6):1294-1297. https://doi.org/10.1161/STROKEAHA.110.581058
Wada K, Arimoto H, Ootani N, Osada H, Tomiyama A, Tomura S, Ueno H, Fujii K, Nagatani K, Takeuchi S, Mori K. CT and histological findings and treatment outcomes after carotid endarterectomy for symptomatic cervical carotid stenosis in octogenarians. No Shinkei Geka. Neurological Surgery. 2014;42(12):1118-1124. https://doi.org/10.11477/mf.14362000046
Antoniou GA, Georgiadis GS, Georgakaros EI, Antoniou SA, Bessias N, Smyth JV, Murray D, Lazarides MK. Meta-analysis and meta-regression analysis of outcomes of carotid endarterectomy and stenting in the elderly. JAMA Surgery. 2013;148(12):1140-1152. https://doi.org/10.1001/jamasurg.2013.4135
Wen L, Wang S, Liu L, Chen L, Geng J, Kuang L, Qian G, Su J, Chen K, Zhou Z. The long-term efficacy and safety of carotid artery stenting among the elderly: a single-center study in China. Behavioural Neurology. 2018;4707104. https://doi.org/10.1155/2018/4707104
Miyawaki S, Maeda K. Surgical treatment for cervical carotid artery stenosis in the elderly: importance of perioperative management of cardiac complication. Neurologia Medico-Chirurgica. 2014;54(2):120-125. https://doi.org/10.2176/nmc.oa2012-0436
Nanto M, Goto Y, Yamamoto S, Takado M, Ogawa T, Nakahara Y. Periprocedural outcomes of carotid artery stenting in elderly patients. Journal of Stroke and Cerebrovascular Diseases. 2018;27(1):103-107. https://doi.org/10.1016/j.strokecerebrovasdis.2017.08.010
Doonan RJ, Abdullah A, Steinmetz-Wood S, Mekhaiel S, Steinmetz OK, Obrand DI, Corriveau MM, Mackenzie KS, Gill HL. Carotid endareterectomy outcomes in the elderly: a Canadian institutional experience. Annals of Vascular Surgery. 2019;59:16-20. https://doi.org/10.1016/j.avsg.2018.12.084
Park H, Kwon TW, Kwon SU, Kang DW, Kim JS, Chung YS, Shin S, Han Y, Cho YP. A retrospective 10-year, single-institution study of carotid endarterectomy with a focus on elderly patients. Journal of Clinical Neurology (Seoul, Korea). 2016;12(1):49-56. https://doi.org/10.3988/jcn.2016.12.1.49
Papoyan SA, Shchegolev AA, Gromov DG, Krasnikov AP, Mutaev MM, Radchenko AN, Sazonov MYu, Syromyatnikov D.D. Stenting of the internal carotid artery in patients of the older age group. Kardiologiya i serdechno-sosudistaya hirurgiya. 2018;11(5):66-68. (In Russ.). https://doi.org/10.17116/kardio20181105166
Ouyang YA, Jiang Y, Yu M, Zhang Y, Huang H. Efficacy and safety of stenting for elderly patients with severe and symptomatic carotid artery stenosis: a critical meta-analysis of randomized controlled trials. Clinical Interventions in Aging. 2015;10:1733-1742. https://doi.org/10.2147/CIA.S91721
Salomon du Mont L, Ravelojaona M, Puyraveau M, Al Sayed M, Ritucci E, Rinckenbach S. Carotid endarterectomy in octogenarian: short- and midterm results. Annals of Vascular Surgery. 2014;28(4):917-923. https://doi.org/10.1016/j.avsg.2013.09.006
Dzierwa K, Pieniazek P, Tekieli L, Musialek P, Przewlocki T, Kablak-Ziembicka A, Kosobucka-Peszat R, Machnik R, Trystula M, Podolec P. Carotid artery stenting according to the «tailored CAS» algorithm performed in the very elderly patients: the thirty day outcomes. Catheterization and Cardiovascular Interventions. 2013;82(5):681-688. https://doi.org/10.1002/ccd.250025
Fantozzi C, Taurino M, Rizzo L, Stella N, Persiani F. Carotid endarterectomy or stenting in octogenarians in a monocentric experience. Annals of Vascular Surgery. 2016;33:132-137. https://doi.org/10.1016/j.avsg.2015.10.039
Mazzaccaro D, Modafferi A, Malacrida G, Nano G. Assessment of long-term survival and stroke after carotid endarterectomy and carotid stenting in patients older than 80 years. Journal of Vascular Surgery. 2019;70(2):522-529. https://doi.org/10.1016/j.jvs.2018.10.121
Abiko M, Sakamoto S, Ochiai J, Yamada N, Kuroki K, Kurisu K. Applicability of carotid artery stenting for patients 80 years or older: a single-center experience. World Neurosurgery. 2018;119:323-327. https://doi.org/10.1016/j.wneu.2018.07.142
Texakalidis P, Chaitidis N, Giannopoulos S, Machinis T, Jabbour P, Rivet D, Reavey-Cantwell J, Rangel-Castilla L. Carotid revascularization in older adults: a systematic review and meta-analysis. World Neurosurgery. 2019;126:656-663.e1. https://doi.org/10.1016/j.wneu.2019.02.030
Qureshi AI, Chaudhry SA, Qureshi MH, Suri MF. Rates and predictors of 5-year survival in a national cohort of asymptomatic elderly patients undergoing carotid revascularization. Neurosurgery. 2015;76(1):34-40. discussion 40-41. https://doi.org/10.1227/NEU.0000000000000551

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