n elderly patients, cardiovascular disease is the most common cause of morbidity and mortality. 1 Elderly subjects with coronary artery disease differ from younger patients in many ways; for example, a previous history of myocardial infarction (MI), unstable angina pectoris, multi-vessel disease and complex lesions are more frequent than in a younger population. [2][3][4][5] Several studies have demonstrated that stent implantation for the treatment of coronary lesions is superior to conventional balloon angioplasty during either a short-or longterm follow-up period. [6][7][8][9][10] Parallel to the developments in procedural techniques and medication, stent deployment for coronary revascularization is being implemented widely in the general population as well as in elderly subjects.The early and late results of percutaneous transluminal coronary angioplasty (PTCA) in the treatment of coronary lesions in elderly subjects are well documented, 2-5,11-13 but data on the long-term results with stent implantation in the elderly are limited. The objective of this study was to examine the long-term clinical and angiographic results in patients aged 65 or over who had undergone intracoronary stent implantation atn a single center.
Circulation Journal Vol.66, November 2002
Methods
PatientsBetween June 1995 and December 1997, 607 consecutive patients underwent 665 coronary stent placements at Kosuyolu Heart and Research Hospital, Istanbul. Of these, 120 patients were aged 65 or over (92 male, 28 female, mean age 72±3.8) and underwent successful placement of 136 coronary stents; 487 patients were younger than 65 years of age (407 male, 80 female, mean age 53±5.9) and underwent 529 coronary stent placements.In the elderly patients, 24% of stents were MULTILINK, 21% were NIR stents, 19% were Wiktor stents, 17% were JO stents, and 19% were different types of stents with no difference when compared with younger patients. All stents were implanted in native vessel lesions, and in the elderly group, 13% had 2 stents. Patients with a contraindication to antiplatelet or anticoagulation therapy were excluded.
Stent PlacementStenting was performed via the femoral approach using an 8Fr sheath and a guiding catheter. Pre-dilatation was performed on all lesions, which determined whether direct stenting would be feasible. Stent deployment was performed by inflation of balloon to a nominal pressure, after which cases that were considered inadequate upon visual angiographic evaluation (residual stenosis >10%) underwent an additional inflation at a higher pressure to achieve a residual diameter stenosis <10%. Inflation pressures higher than 16 atmospheres were discouraged. The ratio of final balloon size to arterial diameter was 1.1±0.1.
Long-Term (3-5 Years) Clinical and Angiographic Follow-up Results of Coronary Stenting in Elderly PatientsKenan Sonmez, MD; Fikret Turan, MD; Murat Gencbay, MD; Muzaffer Degertekin, MD; Ahmet Akçay, MD; Nilufer E Duran, MDThe early and late results of percutaneous transluminal coronary angioplasty in elde...