Abstract 20591: Vascular and Bleeding Complications in Nonagenarians Remain High in the Modern Era of PCI
Introduction: Despite a trend in modern PCI towards reduced bleeding and vascular complications, little is known about the absolute incidence of vascular complications in the very elderly. With older patients routinely being offered PCI, it is important to understand these risks to help guide decision making in this population.
Hypothesis: Nonagenarians have higher vascular complications and bleeding than younger patients following PCI.
Methods: The Dartmouth Dynamic Registry was queried for all PCI’s between 2000 and 2015. Patients were divided into 2 groups based on age (>89 and <90). Demographic and procedural variable were collected for both groups. Vascular (dissection, retroperitoneal bleeding, and pseudoaneurysm formation) and bleeding complications (need for transfusion, large hematoma) were compared between nonagenarians and non-nonagenarians using standard descriptive statistics.
Results: Between 2000-2015, 16,395 patients under 90 years old and 175 nonagenarians underwent PCI (Table 1). In general, nonagenarians had fewer comorbid conditions than younger patients. More nonagenarians had transfemoral access versus radial access. Bleeding requiring transfusion was four-fold higher in nonagenarians and vascular complications were at least twice as likely when compared to younger patients (Table 2).
Conclusion: The overall number of nonagenarians undergoing PCI remains small. However, nonagenarians have significantly higher rates of bleeding and vascular injury when compared to younger patients.
Author Disclosures: S.X. Li: None. H.I. Chaudry: None. B.W. Andrus: None. T.B. Curran: None. S.M. Conley: None. N.I. Buss: None. J.T. DeVries: None.
- © 2016 by American Heart Association, Inc.