Carotid endarterectomy in patients less than 50 years old

Abstract

Our data show that there is a high incidence of smoking and symptomatic presentation among young patients in whom carotid occlusive disease develops. CEA may be performed in young patients with low perioperative morbidity and mortality rates. Recurrent disease, late stroke, and survival rates are not significantly different than for older patients. Follow-up with serial duplex ultrasound and reoperation for symptomatic and high-grade asymptomatic restenosis may decrease the risk of late stroke.

Distribution of Risk Factors in Patients with Premature Coronary, Supra-Aortic Branches and Peripheral Atherosclerotic Disease

“…Our findings that smoking and a family history of atherosclerotic disease were the main risk factors for premature atherosclerosis in young adults confirmed the results of previous studies [2,3,4,5,7,8,11,16]. In a Bogalusa study [11], the autopsy results showed more distinct symptoms of subclinical atherosclerosis among younger persons with multiple risk factors aged between 2 and 39 years than among persons without risk factors.…”

“…In this group the higher incidence of smoking (87.5 vs. 57.4%; p < 0.001) among study patients compared with control patients is similar to that in previous studies [3,4,20,21], thereby suggesting that younger patients are more likely to be smokers at presentation. For HTN, the approximately equal prevalence in both the study group (76.1%) and the control group (71.1%) is similar to the findings of Martin et al [3] and Ballotta et al [20].…”

“…For HTN, the approximately equal prevalence in both the study group (76.1%) and the control group (71.1%) is similar to the findings of Martin et al [3] and Ballotta et al [20]. However, a number of other studies [4,20,21] have reported a higher frequency of HTN in patients less than 50 years of age.…”

“…Differences with previous studies are noticed with respect to gender and DM. Most articles report [3,4,20,21] similar frequencies of patients with DM and gender distribution, with no statistically significant difference between young and older control patients. Our analysis revealed that patients under 50 years of age with supra-aortic branch disease, compared with a randomly selected control group of older patients, had a higher prevalence of DM (28.5 vs. 14.7%, p = 0.017).…”

“…In some studies, as many as 90–95% of younger patients had one or more traditional risk factors for atherosclerosis and different risk factor profiles, clinical presentations, and prognoses compared to older patients [2,3,4,5]. It is important to emphasize that about 60% of premature coronary artery disease (CAD) clusters in families [6].…”