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Pensacola, FL
A 61-year-old female asked:

My mom is 90 years old with asymptomatic 80% blocked carotid artery . on aggrenox. bp and cholesterol well controlled. ? advise surgery tx or stent?

2 doctor answers6 doctors weighed in
Dr. J Roberts
Vascular Surgery 28 years experience
CEA or nothing: Carotid stents are relatively contraindicated in > 80 yrs old; CEA (endarterectomy) is high risk but safe in competent hands. The risk of heart attack is elevated in CEA pts > 80 yrs old, while stroke was higher (and more disabling) w/ stents (cas). In pts > 80 yrs old w/ good heart, lungs , and kidney fxn, CEA is tolerated well. Aspirin & Plavix (clopidogrel) is not superior to stroke prevention v. Cea.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Michael Korona
Radiology - Interventional 34 years experience
Best to discuss: Your mother's case with a neurologist. Make sure she is really not having symptoms. Cta scan with perfusion can see how the flow to her brain is affected by the narrowing. Abnormal perfusion suggests that treatment is necessary. Your neurologist will help you decide between stenting and surgery. I routinely stent people over 80 and have stented a few 90 year olds. Stents are safe.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Creighton Wright
surgery 57 years experience
Asymptomatic for sure? No progression? No mandate to intervene!
Nov 10, 2013
Dr. Timothy Wu
Dr. Timothy Wu commented
Vascular Surgery 19 years experience
This is bad advice. To suggest that perfusion scans are somehow a standard in determining if a carotid artery lesion needs to be treated shows a poor understanding of the disease itself. Furthermore there is plenty of data that points to an increase risk of perioperative stroke in octogenarians (pts > 80 years of age) who undergo stents vs a standard endarterectomy.
Feb 9, 2014
Last updated Sep 30, 2015

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