A Retrospective 10-Year, Single-Institution Study of Carotid Endarterectomy with a Focus on Elderly Patients
Hojong Park1, Tae Won Kwon2, Sun U Kwon3
1Department of Surgery, Ulsan University Hospital, Ulsan, Korea.
Insights
Carotid endarterectomy (CEA) is a safe and effective surgery for carotid artery stenosis, yielding acceptable outcomes in stroke and mortality over a decade. This procedure is suitable for elderly patients, demonstrating good life expectancy and safety.
Area of Science:
- Vascular Surgery
- Neurology
- Geriatric Medicine
Background:
- Carotid artery stenosis poses a significant risk of stroke.
- Surgical intervention, specifically carotid endarterectomy (CEA), is a primary treatment modality.
- The role of aging in surgical outcomes for carotid stenosis requires ongoing evaluation.
Purpose of the Study:
- To evaluate the outcomes of carotid endarterectomy (CEA) over a 10-year period.
- To assess the impact of aging on patient access to and outcomes of CEA.
- To analyze perioperative complications, including stroke and mortality, in relation to patient age.
Main Methods:
- A retrospective review of 649 carotid endarterectomies (CEAs) performed between 2001 and 2010.
- Patients were stratified into three age groups: <70, 70-79, and ≥80 years.
- Data analysis included patient characteristics, comorbidities, stroke, mortality, restenosis, and surgical complications.
Main Results:
- The perioperative stroke and death rate within 30 days was 1.84%.
- Overall mortality was higher in older age groups (70-79 and ≥80 years) compared to the <70 years group.
- No significant difference in stroke-related mortality was observed across the age groups.
Conclusions:
- Carotid endarterectomy (CEA) demonstrates acceptable outcomes regarding stroke and mortality over a 10-year period.
- CEA is a safe and effective treatment for carotid artery stenosis, even in elderly patients.
- Elderly patients undergoing CEA can expect acceptable life expectancy and outcomes.
Background And Purpose:
This study evaluated the outcome following surgery for carotid artery stenosis in a single institution during a 10-year period and the relevance of aging to access to surgery.
Methods:
Between January 2001 and December 2010, 649 carotid endarterectomies (CEAs) were performed in 596 patients for internal carotid artery occlusive disease at our institution; 596 patients received unilateral CEAs and 53 patients received bilateral CEAs. Data regarding patient characteristics, comorbidities, stroke, mortality, restenosis, and other surgical complications were obtained from a review of medical records. Since elderly and high-risk patients comprise a significant proportion of the patient group undergoing CEAs, differences in comorbidity and mortality were evaluated according to age when the patients were divided into three age groups: <70 years, 70-79 years, and ≥80 years.
Results:
The mean age of the included patients was 67.5 years, and 88% were men. Symptomatic carotid stenosis was observed in 65.7% of patients. The rate of perioperative stroke and death (within 30 days of the procedure) was 1.84%. The overall mortality rate was higher among patients in the 70-79 years and >80 years age groups than among those in the <70 years age group, but there was no significant difference in stroke-related mortality among these three groups.
Conclusions:
CEA over a 10-year period has yielded acceptable outcomes in terms of stroke and mortality. Therefore, since CEA is a safe and effective strategy, it can be performed in elderly patients with acceptable life expectancy.
