[Reconstructive surgery of carotid arteries in patients over 70 years old]

Analysed herein are the immediate outcomes of primary reconstructive operations on carotid arteries performed in conditions of regional anaesthesia in patients over 70 years old and those younger than 60 years old. In each group, we singled out the risk factors of operative surgical treatment. The group over 70 years included a total of 55 patients who endured a total of 61 carotid operations. In the group of patients younger than 60 years, we performed a total of 237 operations on the carotid arteries in 223 patients. The perioperative mortality rate in the over-70-year-old group patients amounted to 1.64% (1 death), and in the group of the patients younger than 60 years old it equalled 1.27% (3 deaths), P>0.5. In the group of the patients over 70 years old, death was caused by ischaemic stroke in the carotid bed operated on. The causes of death in the group of the patients younger than 60 years old included ipsilateral stroke in two patients and acute myocardial infarction in one patient. Non-lethal homolateral stroke was observed in one (1.64%) patient over 70 years and in four (1.69%) patients younger than 60 years old (P>0.5). The <> index amounted to 3.28% and 2.96% in the groups of the patients above 70 and those under 60 years of age, respectively. The peculiarities, observed in the patients over 70 years old were as follows: a high incidence rate of concomitant diseases of the vital systems, a bilateral and an embogenic pattern of the carotid pathology. In the group of patients under 60 years predominating were those with endured stroke - 97 (43.49%) patients; of these, 64 (65.98%) had embogenic atherosclerotic plaques. The immediate results of the reconstructive operations performed on the carotid arteries in patients over 70 and those under 60 years have turned out comparable and quite acceptable.