Carotid Endarterectomy for Patients over 80 Years Old

Abstract

Objective: Carotid endarterectomy (CEA) is one of the surgical treatments for carotid artery stenosis. While a large clinical trial showed that advanced age is a risk factor for CEA, other studies reported contradictory results. The aim of this study was to evaluate the outcomes of CEA in patients aged over 80. Methods:Patients who underwent CEA between January 2012 and June 2015 in our hospital were included, and were divided into either the high age group (>80 years old) or standard group (<80 years old). CEA was the firstline surgical treatment, instead of carotid artery stenting (CAS), for all eligible cases, except where patients were not deemed amenable to general anesthesia or at patients' request not to undergo CEA. Patient background and perioperative complications were assessed and compared statistically between the high age group and standard group.Results: Of a total of 127 patients, 20 (15.7%) were in the high age group. No significant differences in patient background were obtained between the high age group and standard group. Four (20%) cases in the high age group had perioperative complications which were all transient. No significant differences in perioperative complications were obtained between the high age group and standard group Conclusions: It is possible for CEA to be performed safely in the elderly, provided adequate preoperative assessment of the general condition and perioperative management of patients are carried out. We recommend that CEA should not be avoided as a treatment option in the elderly, based solely on patient age.