Octogenarians respond well to interventional radiology arterial procedures

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Seniors over the age of 80 can safely undergo diagnostic angiography and arterial interventions, such as vascular stenting and angioplasty. and do just as well as younger patients, according a study released today during the Society of Interventional Radiology’s (SIR) 33rd annual scientific meeting.

The study included 64 octogenarians, who had arterial angioplasty and/or stenting to treat peripheral arterial disease (PAD), caused by blocked arteries in the legs, or to improve blood flow to the kidneys by opening blocked arteries that deliver blood to that organ, the investigators reported. All were treated as outpatients and followed after discharge from the hospital.

George. G. Hartnell, FRCP, FRCR, chief of cardiovascular and interventional radiology at Baystate Medical Center in Springfield, Mass., and colleagues, compared the outcomes of the treatments in the octogenarians to those of 50- to 79-year-old patients, who had an equivalent procedure during the same time period by the same doctor.

Previously, the risks of angiography, x-ray images of the arteries with contrast and arterial interventions, such as angioplasty and stenting, were thought to increase with age, and older seniors were even excluded from some interventional trials because of the perception that they were too frail to participate, according to the researchers. Hartnell and colleagues noted that some physicians, both interventionalists and referring physicians, incorrectly think that octogenarians requiring these procedures should be admitted to hospitals.

PAD and narrowed renal arteries develop most commonly as a result of atherosclerosis, the hardening of the arteries, which occurs when cholesterol and scar tissue build up, forming a substance called plaque that narrows and clogs the arteries, the authors wrote.

“This is important news for seniors and their doctors. In some cases, doctors may be reluctant to send an older person for treatment. There’s no reason for seniors with leg pain caused by peripheral arterial disease to put up with pain, limited mobility and diminished quality of life. Likewise, treating blocked renal arteries can improve kidney function and treat high blood pressure if caused by diminished renal blood flow,” Hartnell said.

“What is an appropriate treatment at 55 is just as safe and appropriate at 85. Older seniors can be treated as outpatients, and age did not increase the risk. This is very relevant because the incidence of clogged arteries increases with age, and peripheral arterial disease affects 12–20 percent of Americans age 65 and older,” Hartnell noted.

The researchers reported that the risks of interventional radiology procedures are lower than risks of open surgery and are a major advance in medicine for patients.

Overall, seniors (ages 85–93) tolerated the procedures well, avoided surgery and could be treated as outpatients—irrespective of age, according to the researchers.