Safety and Efficacy of Carotid Endarterectomy in Octogenarians

Robert A. Pol*, Michel M. P. J. Reijnen, Mariska Lont, Ignace F. J. Tielliu, Steven M. M. van Sterkenburg, Jan J. A. M. van den Dungen, Clark J. Zeebregts

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)

Abstract

Background: To evaluate the outcome of carotid endarterectomy (CEA) in octogenarians.

Method: Between January 2005 and July 2010, all CEA patients were prospectively recorded. Patients were categorized into those = 80 years of age. Primary outcome measures were hospital duration of stay (HDOS), mortality, any stroke, and postprocedural complications.

Results: In total, 477 patients with carotid artery stenosis were treated with CEA. Seventy-one patients (13%) were >= 80 years of age and 477 (87%) patients were = 80 years of age (P = 0.0001). Fifteen patients (3%) had an early adverse neurologic event, with 7 patients (1.3%) developing a transient ischemic attack, 2 patients (0.3%) a minor stroke with full neurologic recovery, and 6 patients (1.1%) had a major stroke. Forty patients (6.8%) had a postoperative nerve injury. No statistical differences were observed between the younger (= 80 years of age) group despite a significant difference in postoperative delirium (P <0.0001). During follow-up, more fatal cardiac events occurred in the octogenarians group (4.2% vs. 0.4%; P = 0.02). Kaplan-Meier analysis revealed a significantly better survival for the younger patients (log rank test; P = 0.04).

Conclusions: Octogenarians who suffer from carotid artery stenosis can be safely treated by CEA. The increased incidence of postoperative delirium is an important finding and requires extra attention in this vulnerable group.

Original languageEnglish
Pages (from-to)736-742
Number of pages7
JournalAnnals of vascular surgery
Volume27
Issue number6
DOIs
Publication statusPublished - Aug-2013

Keywords

  • HIGH-RISK PATIENTS
  • POSTOPERATIVE DELIRIUM
  • VASCULAR-SURGERY
  • STENOSIS
  • STROKE
  • ATHEROSCLEROSIS
  • COMPLICATIONS
  • DEATH

Cite this