Carotid endarterectomy in octogenerians

Area of Science:

• Vascular Surgery
• Geriatric Medicine
• Cardiovascular Research

Background:

• Carotid endarterectomy (CEA) is a common procedure for preventing stroke.
• Limited data exists on the safety and efficacy of CEA in octogenarian patients (80 years and older).

Purpose of the Study:

• To evaluate the safety and efficacy of carotid endarterectomy (CEA) in patients aged 80 years and older.

Main Methods:

• Retrospective review of 59 CEAs performed in 57 patients aged 80+ between 1993 and 1998.
• Data collected included perioperative mortality, morbidity (neurological events), and long-term follow-up.
• Comparison made with 597 CEAs performed in patients younger than 80 years during the same period.

Main Results:

• The perioperative mortality rate in octogenarians was 5.1%, with a combined mortality and stroke rate of 6.8%.
• Four-year survival, freedom from stroke, and stroke-free survival rates were 78%, 94%, and 75%, respectively.
• Perioperative mortality was significantly higher in octogenarians compared to younger patients (P<0.01).

Conclusions:

• CEA in octogenarians is associated with increased perioperative mortality compared to younger individuals.
• Despite higher risks, CEA provides good long-term survival and stroke prevention in selected octogenarians.
• Careful patient selection and management can make CEA a worthwhile procedure for this elderly population.