Treatment of critical stenosis of internal carotid artery in octogenarians

Krzysztof Ziaja; Arkadiusz Krupowies; Wacław Kuczmik; Damian Ziaja; Marek Kazibudzki; Tomasz Ludyga; Jakub Gęborski

Vol 8, No 1 (2006)

Published online: 2006-03-17

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Treatment of critical stenosis of internal carotid artery in octogenarians

Krzysztof Ziaja, Arkadiusz Krupowies, Wacław Kuczmik, Damian Ziaja, Marek Kazibudzki, Tomasz Ludyga, Jakub Gęborski

Chirurgia Polska 2006;8(1):27-32.

Vol 8, No 1 (2006)

Published online: 2006-03-17

Abstract

Background: It is estimated that yearly over 30,000 patients die in Poland from strokes and even more patients become disabled after the stroke. Strokes are on third place among the causes of death in Poland. It has been established that up to 80% of strokes have an ischaemic nature, however approximately 30-40% of strokes are related to an occlusion of the carotid arteries. The aim of the study was to analyze the early results of operative and endovascular treatment of critical carotid artery stenosis in group of patients in aged over 70.
Material and methods: In summary, between 2002 and 2005, 431 vascular interventions on the carotid arteries were carried out on patients with critical carotid artery stenosis. In 216 patients open surgical reconstructions were done (eversion endarterectomy-eCEA). In the remaining 234 cases, endovascular procedures were undertaken (angioplasty, and stent placement - CAS). This group consisted of 83 (38.4%) patients who were treated by surgical reconstruction while 83 (38.4%) and 142 (60.7%) underwent an endovascular procedure. In this study only patients over 70 were included.
Results: In the study group there was no incident of peri-operative death. In 3 patients (2.1%) after stent implanation and in 4 patients (4.8%) after endarterectomy an ischaemic stroke was recognized. In another 5 (6.2%) patients a RIND was observed after surgical procedure. In some of the patients, a decrease in blood pressure was noticed. However, blood pressure normalized less than 48 hours after the procedure.
Conclusions: Endovascular treatment of critical carotid artery stenosis in older patients is related to lower risk of complications in the peri-operative period.