Effects of patient age on outcomes after carotid endarterectomy

Jeong, Min-Jae; Kwon, Sun U.; Kim, Min-Ju; Han, Youngjin; Kwon, Tae-Won; Cho, Yong‐Pil

doi:10.1097/md.0000000000016781

Cited by 6 publications

(3 citation statements)

References 33 publications

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“…There were 2 cases of stroke with 1 in immediate postoperative period and another late stroke in patients, both occurred in the patients with age >60 years (p=0.134) which is similar to the study done by Jeong MJ et al which concluded that age is an independent risk factor for major adverse events following CEA within 4 years. 13 Summarizing, major complications occurred more frequently in the age group ≥60 years.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Carotid Endarterectomy in a Tertiary Center of Nepal: A Retrospective Study

Kadel

Shrestha

et al. 2021

Journal of Institute of Medicine

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Introduction Carotid endarterectomy for carotid artery disease is one of the surgeries performed by vascular surgeons for carotid artery disease. The objective of this study is to describe the early and late outcome of the patient undergoing carotid endarterectomy and the association between the complication and comorbidities present previously in the patient. MethodsAll patients undergoing carotid endarterectomy at Manmohan Cardiothoracic Vascular and Transplant Centre between April 2010 to April 2020 were included. The follow-up data for upto a year from medical and clinical records, telephone interview regarding the immediate and late postoperative complications in patients with and without comorbidities were investigated and compared. ResultsThe total study population was 42 patients. Two patients (4.7%) developed stroke, one immediately in postoperative period and the other during follow up. There were two deaths (4.7%) postoperatively due to cardiac events and three (7.14%) recurrences of carotid stenosis among whom one (2.5%) developed late stroke. Twenty six patients (61.90%) were symptomatic prior to the procedure of which 20 patients (47.61%) had brain infarct. Overall one year survival was 95.2% post procedure and overall complication rate was 7.14%. The consequence in the form of death and stroke occurred more in the patients with comorbidities (3vs1) p=0.42. ConclusionThe immediate and late postoperative complications following carotid endarterectomy were death (4.7%), stroke (4.7%), cranial nerve injury (9.5%). The most frequent cause of death was postoperative cardiac event. Though major complications occurred more frequently in patients having comorbidities, it was statistically insignificant.

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Section: Discussionmentioning

confidence: 99%

Outcome of Carotid Endarterectomy in a Tertiary Center of Nepal: A Retrospective Study

Kadel

Shrestha

et al. 2021

Journal of Institute of Medicine

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“…Only a few studies have analyzed the associations between age and outcomes of CEA in Asian populations. Jeong et al [ 10 ] reported no significant difference in the risks of perioperative MACE and the 4-year overall incidence of cardiovascular events between younger and elderly patients in Korea. However, the age threshold was 60 years, which was not old enough to represent elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of carotid endarterectomy in octogenarians compared to their younger counterparts: a retrospective observational study

Park,

Yang,

Kim

et al. 2024

Ann Surg Treat Res

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Purpose This study was performed to analyze the association between age and outcomes of carotid endarterectomy (CEA) by comparing postoperative outcomes between octogenarians and younger patients. Methods From November 1994 to December 2022, 1,585 internal carotid arteries of 1,434 patients were enrolled. Patients were stratified into 2 groups: octogenarians (≥80 years old) and non-octogenarians (<80 years old). Primary endpoints were early (≤30 days) outcomes of ipsilateral stroke, any stroke, myocardial infarction, death, and major adverse cardiovascular events (MACE). We also compared overall any stroke and death between the 2 groups. Results One of 132 octogenarians (0.8%) and 17 of 1,453 non-octogenarians (1.1%) experienced ipsilateral stroke within 30 days. Thirty-day MACE occurred in 4 of 132 octogenarians (3%) and 44 of 1,453 non-octogenarians (3%). There were no significant differences in any early (≤30 days) outcomes. Symptomatic status was associated with increased 30-day MACE (odds ratio [OR], 2.610; 95% confidence interval [CI], 1.450–4.696; P = 0.003) and 30-day any stroke (OR, 3.999; 95% CI, 1.627–9.828; P = 0.003). Symptomatic status was also associated with overall any stroke (hazard ratio [HR], 2.885; 95% CI, 1.865–4.463; P < 0.001), but age of ≥80 years was not associated with 30-day MACE, 30-day any stroke, or overall stroke. Age of ≥80 years was only associated with overall survival (HR, 2.644; 95% CI, 1.967–3.555; P < 0.001). Conclusion CEA would be a safe and effective treatment for octogenarians with low 30-day complications and long-term stroke rates, comparable with that of younger counterparts. Advanced age is not a contraindication for CEA.

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“…In fact, there is a range of reports discussing the role of statins in preventing carotid pathologies and highlighting their role in reducing the risk of ischemic stroke [38]. Some of them indicate that statins have an impact on the regression of pathological changes in the carotid artery [39].…”

Section: Discussionmentioning

confidence: 99%

Association between ethnicity and risk factors for carotid artery stenosis: a retrospective study

Shamshiyev¹,

Tergeussizov²,

Baubekov³

et al. 2021

fmpcr

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Background. To date, the correlation between ethnicity and risk factors for the development of stenosis of the carotid arteries has not been evaluated in Kazakhstan.Objectives. The study investigated the link between ethnicity and risk factors for the development of carotid artery stenosis (≥ 50%). Material and methods. The study is based on a retrospective analysis of the data of 356 patients hospitalized with suspected pathology of the carotid arteries. The patients were subdivided into groups according to their ethnic origin, age, and the degree of the narrowing of the internal carotid artery. The demographic data, main risk factors, and the effectiveness of treatment were analyzed.Results. Among all the patients, Central Asians accounted for 56.5%, Slavs for 35.9%, and other nationalities for 7.6%. A high level of obesity, hypertension and hypercholesterolemia, smoking, and low physical activity was prevalent in the group of the Central Asians. However, alcohol consumption was higher in the Slavs. Preventive use of aspirin prevailed in the Slavic patients (64.1%). Male gender, hypercholesterolemia, and low physical activity were risk factors for the development of significant stenosis of the carotid arteries (p < 0.01). Conclusions. The results showed that ethnicity, male gender, overweight, physical inactivity, smoking, and hypercholesterolemia were dominant risk factors for the development of significant carotid stenosis. Our findings indicate the need for the development of preventive measures to combat such risk factors in the amenable ethnic groups.

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Effects of patient age on outcomes after carotid endarterectomy

Abstract: Supplemental Digital Content is available in the text

Cited by 6 publications

References 33 publications

Outcome of Carotid Endarterectomy in a Tertiary Center of Nepal: A Retrospective Study

Outcome of Carotid Endarterectomy in a Tertiary Center of Nepal: A Retrospective Study

Outcomes of carotid endarterectomy in octogenarians compared to their younger counterparts: a retrospective observational study

Association between ethnicity and risk factors for carotid artery stenosis: a retrospective study

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