[CAROTID STENTING EXPERIENCE IN THE ACUTE PHASE OF ISCHEMIC STROKE IN PATIENTS OF ELDERLY AND SENILE AGE].

Age has been shown to be a predictor of neurological complications during carotid stenting (CS). However, carotid stenting in acute period of ischemic stroke has recently been demonstrated safely in patients over 70 and even 80 years. Early intervention is desirable in patients presenting with stroke referable to carotid artery stenosis because of the high incidence of recurrent ischemic events. However, he optimal timing to perform CS in the acute phase of ischemic stroke in elderly remains unclear due to the threat of perioperative complications. In our hospital (Aleksandrovskaya) was searched for consecutive cases of extracranial internal CS procedures performed for symptomatic atherosclerotic carotid stenosis in the acute phase of ischemic stroke in a total of 65 elderly patients. The primary outcome was not statistically different among groups stratified based on intervention timing, with a combined incidence of stroke, MI or death of 5.9 % in patients treated within 2 days, 0% in patients treated between days 3 and 7, 15% in patients treated between days 8 and 14 and 0% in patients treated between days 15 and 30. Our results support the conclusion that early CS (within 2 days) carries no additional risks compared with CAS after 2 days or any other timing of the intervention up to 30 days in elderly.

[Features of carotid stenting in elderly: predictors of adverse outcomes (review of literature)].

This article presents the review of literature devoted to studying of features of carotid angioplasty and stenting (CAS) in older patients. Age has been shown to be a predictor of neurological complications during CAS. However, it has been demonstrated recently that carotid stenting can be performed safely in patients over 70 and even 80 years. According to researchers, predictors of mortality were remote (≥ 6 months) transient ischemic attack or cerebrovascular accident, smoking history, creatinine clearance and hemoglobin level. Better selection of patients using the predictors of mortality may help to reduce unwarranted procedures and to optimize survival likelihood. Furthermore, CAS could be safely performed in elderly patients if certain anatomical and clinical markers such as excessive vascular tortuosity, heavy concentric calcification of the lesion and decreased cerebral reserve were avoided. However, additional randomized trial data are needed.

[Left ventricular hypertrophy as a marker of adverse cardiovascular risk in persons of various age groups].

The paper considers modern conceptions about the prognostic value of left ventricular hypertrophy (LVH) different types. The role of interaction of demographic, hemodynamic, regulatory, intracardiac factors in the formation of prognostic peculiarities in patients with different types of LVH is marked. The data of own investigations indicating that the left ventricular myocardial mass has not less important value in long-term general prognostication than belonging to a concentric or eccentric LVH type in elderly patients with hypertension are presented. Some data concerning left atrial dilatation as an inalienable component of the cardiovascular continuum in essential hypertension are submitted. Pathogenic and prognostic contribution of metabolic disorders associated with hypertension and abdominal obesity in the development of the heart's left parts structural and functional disorders is shown. Issues of long-term outcome in elderly hypertensive patients with metabolic syndrome taking into account the peculiarities of left ventricular geometry are highlighted.