Are You Ever Too Old for an Angioplasty?

Aug. 25, 2006 — -- Former President Gerald Ford, who at 93 underwent a coronary angioplasty with stent placement at the Mayo Clinic in Rochester, Minn., is today one of an increasing number of elderly patients who have undergone this invasive procedure in recent years.

But as the American population ages and more people live into their 90s, questions have been raised about the safety of performing such procedures on the ultra-elderly.

Angioplasty, which improves blood flow to the heart, entails threading a thin tube into the blood vessels of the heart and removing blockages. These blockages prevent blood and oxygen from nourishing the heart, often causing chest pain and heart attack.

In Ford's case, stents -- wire coils that keep the blood vessel open -- were also used to prevent future blockages.

Dr. Lee Green, a primary care physician at the University of Michigan, reports sending elderly patients for angioplasty frequently.

"I had a 94-year-old schoolteacher I sent for angioplasty a couple of years ago, because she was a spry and active woman who was still traveling and enjoying life," Green said.

Many cardiologists echo Green's sentiment, saying that decisions about invasive procedures should be made individually. A generally healthy patient, without other significant diseases, might be a candidate for angioplasty.

"Some patients in their 90s, particularly those who live active, vibrant lives, as President Ford seems to, can also successfully undergo angioplasty," said Dr. Deepak Bhatt, interventional cardiologist at the Cleveland Clinic.

However, concerns remain about the risks this procedure poses for the very elderly.

Though few studies have examined the risk to patients over the age of 80, there is some evidence that as patients age, the risk of complications from the procedure increases.

A review of patients at the University of Michigan found two times the risk of death or major complications in patients over the age of 80, according to Dr. Mauro Moscucci, associate professor of internal medicine and a cardiologist at the University of Michigan.