Carotid artery stenting for a nonagenarian presenting as stuttering stroke

Carotid artery stenting (CAS) is performed in patients with minor strokes and transient ischemic attacks (TIAs) to prevent further strokes. However, most operators do not intervene in older adults. We had a 92-year patient with recurrent minor strokes with two possible proximate causes - cardioembol...

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Bibliographic Details
Published in:Annals of the Indian Academy of Neurology 2022-07, Vol.25 (4), p.715-717
Main Authors: Fatima, Saman, Garg, Ajay, Joseph, Leve, Padma Srivastava, M, Vibha, Deepti, Bansal, Raghav, Bindra, Ashish, Tripathi, Manjari, Singh, Rajesh, Elavarasi, Arunmozhimaran
Format: Article
Language:English
Subjects:
Aged patients
Blood vessels
Care and treatment
Carotid artery
Carotid artery diseases
carotid stenosis
carotid stenting
Case studies
Comorbidity
dual etiology of stroke
Endovascular stents
Grand Round
Ischemia
Nonagenarian
Stenosis
Stroke (Disease)
stroke in older adults
Surgery
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Summary:Carotid artery stenting (CAS) is performed in patients with minor strokes and transient ischemic attacks (TIAs) to prevent further strokes. However, most operators do not intervene in older adults. We had a 92-year patient with recurrent minor strokes with two possible proximate causes - cardioembolism and significant symptomatic left carotid stenosis. This patient continued to have recurrent ischemic events in the left carotid territory despite optimum management of the cardioembolic source with dual antiplatelets and anticoagulation and was successfully treated with left CAS. The role of carotid revascularization in older patients with high-grade symptomatic carotid stenosis and cardiac comorbidities is discussed.
ISSN:0972-2327
1998-3549
DOI:10.4103/aian.aian_14_22