Carotid endarterectomy as the criterion standard in high-risk elderly patients

Archives of Surgery
Ahmed SulimanNiren Angle

Abstract

Carotid angioplasty and stenting (CAS) is now a viable alternative to carotid endarterectomy (CEA) in patients considered to be high-risk candidates for surgery, despite recent reports of increased adverse periprocedural outcomes in elderly patients. We sought to evaluate our single-institution experience and the 30-day perioperative outcomes of CEA in patients 75 years or older, who are traditionally considered high-risk surgical candidates and are recommended for CAS. Retrospective medical record review. Academic tertiary care center. All patients 75 years or older undergoing CEA during a 16-year period. Primary outcome of 30-day perioperative stroke, death, or myocardial infarction (MI) and a composite outcome of stroke, death, or MI. Secondary outcomes of all perioperative complications were exclusive of primary outcomes. One hundred seventeen CEAs were performed in 110 patients 75 years or older. Significant medical comorbidities were well represented among the group. Among the patients, 50.4% were symptomatic, 60.7% had greater than 90% carotid stenosis, and 44.4% had contralateral disease. Primary outcome for any stroke, death, or MI was 1.7%, 0.9%, or 3.4%, respectively, with a composite event rate of any stroke or deat...Continue Reading

Citations

May 3, 2014·Annals of Vascular Surgery·Lucie Salomon du MontSimon Rinckenbach
Dec 4, 2009·Cerebrovascular Diseases·Judith H LichtmanLarry B Goldstein
May 17, 2011·The American Journal of Geriatric Pharmacotherapy·Ahmed Alhusban, Susan C Fagan
Dec 25, 2009·Circulation. Cardiovascular Interventions·William A GrayUNKNOWN Investigators and the Executive Committees

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