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Research sheds light on carotid artery stenting risk in elderly
Date:11/1/2007

re analyzed. There was a positive correlation between age and aortic arch calcium content and the mean calcium score for patients increased by decade. There was significantly more arch calcium in patients 75 years or older. Because elderly patients may develop elongated and tortuous arches, the research team also examined whether arch type was associated with calcium content. Patients with type II aortic arches, a class of more complex anatomy, had a higher calcium content compared with patients with type I aortic arches.

These findings suggest that increased aortic arch calcium content and arch elongation may be used as markers of increased potential for embolization during endovascular manipulation of the aortic arch. Multiple reports have documented an increased periprocedural stroke risk with CAS in octogenarians. An increased stroke risk in elderly patients is likely to prevent widespread applicability of CAS in these patients.

According to the American Heart Association, on average, every 45 seconds, someone in the United States has a stroke500,000 a first stroke and 200,000 recurrent attacks each year. Eighty-seven percent of strokes are ischemiccaused by blocked blood flow. The prevalence of transient ischemic attacks (mini strokes that last less than 24 hours) increases with age. Stroke is the third leading cause of death in the US accounting for 1 in every 16 deaths in 2004.

Early identification of these arches at higher risk for embolic complications may allow planning of alternative techniques associated with less manipulation of the arch, such as the use of soft-tip guide catheters rather than stiff sheaths or use of the transcervical approach, said Dr. Bazan. These maneuvers could potentially decrease the periprocedural risk of stroke. I think more and more physicians will regard age as a patient-specific factor that is a marker for aortic arch calcification and arch complexity. Preprocedural determination of aortic arch morphology a
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Contact: Leslie Capo
lcapo@lsuhsc.edu
504-452-9166
Louisiana State University Health Science Center
Source:Eurekalert

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