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Carotid surgery in octogenarians: why not?
1Centre Hospitalier Régional du Suroît, POB 291, Valleyfield, Quebec, Canada J6S 4V6. bcartier@rocler.qc.ca
Annals of Vascular Surgery
|October 23, 2002
Summary
Carotid endarterectomy is effective in octogenarians. Outcomes for patients over 80 were comparable to younger groups, supporting its use in older individuals.
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Neurology
Background:
- Carotid endarterectomy (CEA) is a proven stroke prevention procedure.
- Exclusion of octogenarians in prior CEA studies raises questions about its efficacy in this demographic.
Purpose of the Study:
- To compare the outcomes of CEA in patients aged 80 and over versus those younger than 80.
- To evaluate the safety and efficacy of CEA in the octogenarian population.
Main Methods:
- Retrospective review of 475 CEAs performed between July 1990 and February 2001.
- Analysis of perioperative neurological events and mortality in patients under 80 and those 80 or over (n=65).
Main Results:
- Comparable perioperative neurological events and mortality rates were observed between the two age groups.
- Over 70% of octogenarian patients remained alive at 4-year follow-up.
Conclusions:
- Carotid endarterectomy demonstrates comparable safety and efficacy in octogenarians compared to younger patients.
- The established indications for CEA should be applied to octogenarian patients.