Supra-aortic Stenting Experiences in Over Eighty Year Old Patients

INTRODUCTION: Stroke is a common disease at any age but it is mostly seen in older population. Increasing aging of the population all over the world boostes importance of primary and secondary prevention measures for stroke. Carotid artery stenosis is observed in 10% of people over 80 years of age. Our aim is to share the clinical results and outcomes of patients over 80 years of age who underwent supraaortic stenting.
METHODS: In this study we examined retrospectively 25 patients which are over 80 years of age and underwent supra-aortic stenting between January 2014- January 2017 in Gaziantep University Neurology Clinic. Patients were examined for vascular risk factors. Patient with symptomatic carotid artery (>50%) and vertebral artery stenosis (>60%) underwent stenting. Vascular complications and clinical results are recorded
RESULTS: Twenty-five patients were included in study. 15 (60%) of these patients were male and 10 (40%) were female. The mean age of the patients was 81.33 ± 1.63. 40% of patients had previous stroke history or transient ischemic attack (TIA), 36% of them had hypertension (HT), 20% of them had coronary artery disease (CAD), 8% of them had hyperlipidemia (HL) and 8% of them had diabetes mellitus (DM). 25 patients applied 31 stenting. 1 (4%) patient had periprocedural asystole and 4(16%) patients had periprocedural bradycardia. There was an infarction of the middle cerebral artery (MCA) ipsilateral to the stent in 1 (4%) patient. Reperfusion bleeding did not occur in any patient. 2 (8%) patients had post-procedural encephalopathy and agitation lasting shorter than 24 hours. Hypotension was observed in 8 patients (32%). Twelve (48%) patients had post-procedural headache lasting shorter than 24 hours.
DISCUSSION AND CONCLUSION: Supra-aortic stenting in patients over 80 years of age is a treatment modality in which the complication rate is low if the appropriate case is selected.

Seksen Yaþ Üstü Hastalarda Supraaortik Stentleme Tecrübelerimiz

GÝRÝÞ ve AMAÇ: Ýnme her yaþta görülebilir, ancak çoðunlukla yaþlýlarda ortaya çýkar. Bütün dünyada nüfusun giderek yaþlanmasý, bu yaþ grubunda inme için primer ve sekonder koruma tedbirlerinin önemini artýrmaktadýr. Seksen yaþ ve üstü kiþilerin de %10’unda karotis arter stenozu olduðu saptanmýþtýr.Amacýmýz supraaortik stentleme yapýlan 80 yaþ üstü hastalarýn klinik verilerini ve sonuçlarýný paylaþmaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþma 2014-2017 yýllarý arasýnda Gaziantep Üniversitesi Nöroloji Kliniði’nde stent takýlan 80 yaþ üstü 25 hastanýn bilgileri retrospektif olarak incelendi.Hastalarýn vasküler risk faktörleri belirlendi. Semptomatik karotis arter dalýðý (>%50) ve vertebral arter darlýðý (>%60) olan hastalara stentleme uygulandý sonrasýnda gözlenen vasküler komplikasyon ve klinik bulgular kaydedildi.
BULGULAR: Çalýþmaya 25 hasta dahil edildi. Bu hastalarýn 15’i (%60) erkek, 10’u (%40) kadýndý. Hastalarýn ortalama yaþý 81,33±1,63 olarak saptandý. Hastalarýn %40 da geçirilmiþ iskemik inme veya GÝA, %36 da hipertansiyon (HT), %20 de koroner arter hastalýðý (KAH), %8 hiperlipidemi (HL), %8 diabetes mellitus izlendi.Toplamda 25 hastaya 31 defa stent uygulamasý yapýldý.Ýþlem sýrasýnda 1 (% 4) hastada asistol, 4 (% 16) hastada bradikardi geliþti, 1 (% 4) hastada stentle ipsilateral bir orta serebral arter (MCA) dalý enfarktüsü vardý. Reperfüzyon kanamasý herhangi bir hastada görülmedi. 2 (% 8) hastada ensefalopati ve 24 saatten az süren ajitasyon gözlendi. Hipotansiyon 8 (% 32) hastada ve 12 (% 48) hastada 24 saatten kýsa süren baþ aðrýsý belirlendi.
TARTIÞMA ve SONUÇ: Sonuç olarak 80 yaþ üstü hastalarda supraaortik stentleme, uygun vaka seçildiði takdirde komplikasyon oranýnýn düþük olduðu bir tedavi yöntemidir.