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Differences in Complications and Patency Rates in Young and Elderly Patients Undergoing Extra-Intracranial Bypass

Davide M Croci1, Jeffrey Farooq2, Molly Monsour2

  • 1Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, Florida, United States.

Journal of Neurological Surgery. Part A, Central European Neurosurgery
|May 15, 2025
PubMed

Insights

Extra-Intracranial (EC-IC) bypass surgery is safe and effective for patients 70 and older, showing similar complication and patency rates compared to younger individuals. Age is not the primary factor in determining EC-IC bypass suitability.

Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Geriatric Medicine

Background:

  • Extra-Intracranial (EC-IC) bypass surgery addresses hemodynamic insufficiency and cerebral ischemia.
  • An aging population increases the incidence of conditions requiring EC-IC bypass.
  • Evaluating EC-IC bypass outcomes in elderly patients is crucial.

Purpose of the Study:

  • To analyze complications and patency rates of EC-IC bypass in patients aged 70 years and older.
  • To compare these outcomes with a younger cohort (<70 years).
  • To determine the efficacy and safety of EC-IC bypass in the elderly population.

Main Methods:

  • Retrospective review of patient charts for diagnosis, presentation, bypass type, and outcomes.
  • Comparison of 17 patients (≥70 years) with 158 patients (<70 years) who underwent arterial bypass.
  • Assessment of medical/surgical complications and graft patency rates (postoperative and follow-up).

Main Results:

  • No significant differences in overall medical and surgical complication rates between older and younger patients.
  • Similar direct postoperative and follow-up graft patency rates (88.2% older vs. 88.3% younger).
  • Younger patients were more likely to undergo bilateral bypass (28.1% vs. 0%; p=0.01).

Conclusions:

  • EC-IC bypass is safe and effective in patients aged 70 years and older.
  • Outcomes are comparable to younger patients, suggesting age is not the sole determinant of benefit.
  • Further research should explore factors beyond age for patient selection.

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