Coronary stenting in the elderly: longitudinal results in a wide spectrum of patients treated with a new and more practical approach

Abstract

One hundred-twelve intracoronary stents (83 Palmaz-Schatz, 25 biliary, and 4 Gianturco-Roubin) were placed in 87 (51.7% male) patients aged > or = 70 years (70-93; mean 76.1) during a 1-year period. All stents were deployed using high-pressure inflation (mean 17.4 +/- 2 atm) without intravascular ultrasound. All patients received antiplatelet therapy with aspirin and ticlopidine. Seven patients additionally received warfarin at the physician's discretion. No patient was excluded from analysis regardless of presentation (40% acute myocardial infarction and 12.6% bailout) or complication. There were four deaths and two target vessel reinterventions in-hospital. One reintervention (a bailout) developed a non-Q-wave myocardial infarction. Bleeding, vascular complications, and length of stay were all greater for the warfarin group. The event-free survival rate was 83.9%, at an average of 8.6 months follow-up. A wide range of elderly patients can thus undergo stenting without intravascular ultrasound, usually without warfarin, yielding results comparable to those with more standard therapy in select populations.