The management of asymptomatic carotid stenosis: Is there a benefit to operate elderly patients?

Abstract

Background We present a retrospective study of a series of 40 patients over the age of 75 operated for an asymptomatic carotid stenosis. The results were evaluated during an average of 3 years of follow-up. Material and method The study is retrospective and monocentric. The series includes 40 patients aged over 75 years and with an average age of 78.5 years (range 75–82). Patients underwent surgery for an asymptomatic carotid stenosis of more than 80%. The technique in all case was a carotid endarterectomy. Results There have been no postoperative deaths or neurological adverse events. During an average follow-up of 3 years, there was one death secondary to colon cancer. However, 5 patients were lost to follow-up. Conclusion Carotid surgery in elderly patients may have a benefit. However, our study has shortcomings. It is retrospective and the patient cohort is reduced. A randomized, prospective study, comparing surgery or angioplasty with the best medical treatment, is necessary to choose the most effective and safest treatment to offer to an elderly patient with asymptomatic carotid stenosis.

Good practices for a “Decade for Active and Healthy Ageing”

“…There are evidences on how early interventions can reduce the risk of stroke in patients with asymptomatic carotid stenosis (ACS). Professional training is a key element to ensure that prevention interventions are actually uptaken in current practice: sharing experiences and knowledge at international level is an opportunity we must not miss [ 4 ].…”