German Study Evaluates CAS Outcomes in Clinical Practice Depending on Patient Age


September 27, 2017—An assessment of acute and long-term, age-dependent outcomes of carotid artery stenting (CAS) in a German single-center, real-world registry was published by Jakob Ledwoch, MD, et al in Catheterization and Cardiovascular Interventions (2017;90:451–460).

The investigators found that patients aged ≥ 75 years had poorer outcomes after CAS compared with younger patients. Importantly, age did not influence the outcome in asymptomatic patients and the risk for stroke beyond the periprocedural period.

The analysis included all symptomatic and asymptomatic patients who consecutively underwent CAS at Städtisches Klinikum München in Munich, Germany. The population was divided into three groups dependent on patients' age (< 65, 65–74, and ≥ 75 years).

As summarized in Catheterization and Cardiovascular Interventions, between 1999 and 2015, a total of 878 patients (24%, < 65 years; 40%, 65–74 years; and 36%, ≥ 75 years) underwent CAS.

The rate of the primary endpoint (30-day composite of major adverse cardiovascular and cerebrovascular events [death, stroke, and myocardial infarction] plus long-term ipsilateral stroke) was higher in patients aged ≥ 75 years compared with the middle-age group (hazard ratio [HR] 2.3; confidence interval [CI] 1.22–4.36; P = .001). Similarly, the rate of the stroke endpoint (30-day any stroke plus long-term ipsilateral stroke) was higher in patients aged ≥ 75 years compared with patients aged 65 to 74 years (HR, 2.03; CI, 1.01–4.10; P = .04).

There was no significant age-dependent difference in the primary endpoint and stroke endpoint in the subset of asymptomatic patients. Furthermore, age had no influence on the risk of stroke beyond the periprocedural period, reported the investigators in Catheterization and Cardiovascular Interventions.


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