摘要
客观颈动脉 angioplasty 和 stenting (CAS ) 被建议了是在有高风险的病人的选择的过程心血管的侧面。不幸地，如此的病人与几 comorbidities 经常是年老的，例如复杂化 CAS 表演的冠的动脉疾病，外部动脉疾病和敌对解剖的高流行。我们寻求了在老病人评估 CAS 的结果，构画出遇到的挑战和最终的建议全球心血管的管理。我们回顾地在数据库找了病人的方法 > 被指的 65 岁的孩子心血管的诊断和 Endoluminal 干预， Rovigo 医院将军，在为 CAS 的 24 月的经期(12 月 2007-November 日 2009 ) 上。冠的 angiography 并且外部屏蔽在所有病人被执行。所有最终的挑战和相关答案被分析。完全结果， 160 个病人被注册。在哪个之中， 50 个病人(31.2% ，意味着年龄 80 搠癥？
Objective Carotid angioplasty and stenting （CAS） has been suggested to be the procedure of choice in patients with high risk cardiovascular profile. Unfortunately, such patients are often aged with several comorbidities, such as a high prevalence of coronary artery disease, peripheral artery disease and hostile anatomy that complicate the CAS performance. We sought to evaluate the results of CAS in elderly patients, outlining the encountered challenges and the eventual proposed global cardiovascular management. Methods We retrospectively searched the database for patients 〉 65-year-old who were referred to Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, over a 24-month period （December 2007-November 2009） for CAS. Coronary angiography and peripheral screening were performed in all patients. All eventual challenges and related solutions were analyzed. Results Totally, 160 patients were enrolled. Among which, 50 patients （31.2%, mean age 80 ~ 6.4 years） underwent CAS over a 24- month period： 24 patients （48%） had concurrent coronary artery disease （three-vessel in 7 patients, bivessel in 8 patients, single vessel in 5 patients and left main in 4 patients）; 13 patients （26%） and peripheral artery disease at the site of arterial access; 15 patients and type III aortic arch （30%）, 7 patients severe tortuosity of the common carotid artery （14%）, and 8 angulated takeoffof carotid or internal artery （16%）. Concurrent percutaneous coronary intervention was performed in 14 patients, including 3 patients with left main disease. Concurrent peripheral intervention was performed in 7 patients （ all with bilateral common or external critical disease） due to the impossibility to gain another access. Successful carotid cannulation was achieved in all patients with hostile neck. Two-wire technique has been used in 17 patients, three-wire technique in 9 patients, and four-wire technique in 4 patients. Conclusion Elderly patients submitted to CAS represent a complex and challenging subgroup in which often cardiac and peripheral technical expertise is required to gain success of the procedure： interventional cardiologists are probably the preferred performers in such complex patients （JGeriatr Cardio12010; 7：3-6）.
