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Carotid stenosis. Surgery after 75 years.
Summary
Carotid endarterectomy is a safe and effective procedure for patients over 75. This study found similar complication rates and low long-term risks, especially benefiting asymptomatic individuals or those with transient ischemic attacks (TIA).
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Neurology
Background:
- Carotid artery stenosis poses a significant stroke risk.
- Surgical intervention, carotid endarterectomy (CEA), is a standard treatment.
- The safety and efficacy in elderly patients (≥75 years) remain a subject of investigation.
Purpose of the Study:
- To evaluate the safety and long-term outcomes of carotid endarterectomy in patients aged 75 years and older.
- To determine if advanced age influences perioperative morbidity and late neurological complications.
Main Methods:
- Retrospective analysis of 66 patients aged 75-87 years who underwent 76 carotid endarterectomies.
- Assessment of perioperative mortality, morbidity, and general complications.
- Long-term follow-up (2-94 months) for secondary neurological events and restenosis.
Main Results:
- One perioperative death occurred in 76 procedures.
- Morbidity and general complication rates were comparable to younger patient cohorts.
- Low incidence of secondary neurological complications (13 cases) and re-stenosis (2 cases) observed during follow-up.
Conclusions:
- Carotid endarterectomy is a reasonable and beneficial procedure for elderly patients (≥75 years).
- The procedure demonstrates acceptable safety and efficacy in this demographic.
- Asymptomatic patients and those with transient ischemic attacks (TIA) particularly benefit from CEA.