[Results of carotid endarterectomy in octogenarians: a 10-years personal experience]

Some investigators consider octogenarians as high risk patients for carotid endarterectomy (CEA). The objective of our study was determine the results of CEA in the octogenarians patients.

Between January 1998 and May 2008, 755 CEAs were performed by the first author. Of these, 73 (9.7%) were performed in 69 octogenarians (40 men, 29 women) with a median age of 83 years (range, 80 to 90 years ). Before the procedures, 46 patients (63%) were asymptomatic and 27 (37%) had a severe (>70%) asymptomatic stenosis. Hypertension (68.1%), tobacco history (47.8%) and ischemic cardiopathy (39.1%) were the most prevalent comorbidities. Surgical data and perioperative results such as ocurrence of stroke, transitory ischemic atacks, need for re-operation and death as a long term survival estimate by Kaplan Meier method were analysed.

Of all 73 operations, there was two early (<30 days( postoperative deaths (2.7%) due to pulmonary sepsis in a patient submitted to myocardial revascularization simultaneously and due to a fatal stroke in another patient. There was one non-fatal stroke (1.4%) due to early (eighth post-operative day) carotid thrombosis; and one non-fatal myocardial infarction (1.4%). Another four patients (5.5%) were submitted to early reoperation due to neck hematoma. Of patients that have been discharged (n=67), late information was available in 55 patients (82.1%) and the Kaplan-Meier estimated 5-year survival rate was 60.6%.

We conclude that CEA may be performed in selected octogenarians patients to treat carotid occlusive disease with good results. Therefore, age alone should not be considered as a prohibitive risk factor for patients candidates for CEA.