PERIOPERATIVE OUTCOMES AND LONG TERM SURVIVAL AFTER CAROTID ENDARTERECTOMY IN ELDERLY PATIENTS

  • Mário Moreira Angiology and Vascular Surgery Department Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Vânia Constâncio Angiology and Vascular Surgery Department Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Joana Silva Angiology and Vascular Surgery Department Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Pedro Lima Angiology and Vascular Surgery Department Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Mafalda Correia Angiology and Vascular Surgery Department Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Luís Antunes Angiology and Vascular Surgery Department Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Joana Moreira Angiology and Vascular Surgery Department Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Manuel Fonseca Angiology and Vascular Surgery Department Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Keywords: Carotid, Endarterectomy, Elderly

Abstract

Introduction: Stroke is a major health problem. Overall, 10–15% of all strokes are related to a previous asymptomatic carotid stenosis >50%. Carotid endarterectomy (CEA) is e!ective in stroke prevention; risk/benefit assessment is less apparent for elderly. The authors evaluate department CEA outcomes in elderly population aged 75 years and older, focusing in perioperative outcomes and long term survival.

Material and methods: Retrospective unicentric analysis was performed, encompassing 156 surgeries in 149 patients aged 75 years and older, between January 2010 and December 2017.

Results: Perioperative stroke/mortality was 2.6% (4.0% for symptomatic, 0% for asymptomatic); perioperative morbidity was 6.4%; estimated "ve-year survival was 71.9%.

Conclusion: CEA continues to be a low-risk approach to treat carotid bifurcation atherosclerosis, even in elderly population, with perioperative morbidity and mortality resembling international standards for general population. Long term survival is quite good and age alone should not be a reason to refrain from offering carotid endarterectomy to this patients.

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Published
2020-02-05
Section
Original Article