[Clinical course and therapy of carotid stenosis in old age]

From 1977 to 1981 266 patients suffering from partial carotid occlusive diseases were operated, 50% of them older than 65 years, the eldest 87 years. The prognosis is the same in both groups, the good results range higher than 80%, mortality was even lower than in younger patients. Local anesthesia is preferred, it allows an optimal observation and earliest detection of operative mistakes and neurological deficits. The incidence of contralateral involvement is 33%. 25% of male patients needed preceding contralateral EIA-operation because of a missed complete thrombosis. Furthermore the importance of kinking is stressed, because its reconstruction without arteriotomy and risk was possible in nearly all cases. Despite all advantages in vascular surgery, cerebral symptoms always call for investigation of the brain and not for vascular tests only: the amount of cerebral operations is still five times higher than that of carotid disorders and 500 times higher than procedures on the aortic arch.