J Clin Neurol.  2016 Jan;12(1):49-56. 10.3988/jcn.2016.12.1.49.

A Retrospective 10-Year, Single-Institution Study of Carotid Endarterectomy with a Focus on Elderly Patients

• Park H
• Kwon TW
• Kwon SU
• Kang DW
• Kim JS
• Chung YS
• Shin S
• Han Y
• Cho YP

• KMID: 2364919
• DOI: http://doi.org/10.3988/jcn.2016.12.1.49

Abstract

BACKGROUND AND PURPOSE
This study evaluated the outcome following surgery for carotid artery stenosis in a single institution during a 10-year period and the relevance of aging to access to surgery.
METHODS
Between January 2001 and December 2010, 649 carotid endarterectomies (CEAs) were performed in 596 patients for internal carotid artery occlusive disease at our institution; 596 patients received unilateral CEAs and 53 patients received bilateral CEAs. Data regarding patient characteristics, comorbidities, stroke, mortality, restenosis, and other surgical complications were obtained from a review of medical records. Since elderly and high-risk patients comprise a significant proportion of the patient group undergoing CEAs, differences in comorbidity and mortality were evaluated according to age when the patients were divided into three age groups: <70 years, 70-79 years, and > or =80 years.
RESULTS
The mean age of the included patients was 67.5 years, and 88% were men. Symptomatic carotid stenosis was observed in 65.7% of patients. The rate of perioperative stroke and death (within 30 days of the procedure) was 1.84%. The overall mortality rate was higher among patients in the 70-79 years and >80 years age groups than among those in the <70 years age group, but there was no significant difference in stroke-related mortality among these three groups.
CONCLUSIONS
CEA over a 10-year period has yielded acceptable outcomes in terms of stroke and mortality. Therefore, since CEA is a safe and effective strategy, it can be performed in elderly patients with acceptable life expectancy.

Keyword

endarterectomy; carotid; carotid stenosis; stroke

MeSH Terms

Aged*
Aging
Carotid Artery, Internal
Carotid Stenosis
Comorbidity
Endarterectomy
Endarterectomy, Carotid*
Humans
Life Expectancy
Male
Medical Records
Mortality
Retrospective Studies*
Stroke

Figure

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  Fig. 1 Survival in the patients stratified according to age as follows: 70 years, 70-79 years, and ≥80 years. Kaplan-Meier curve illustrating the overall survival relative to age. Patients aged 70-79 years and ≥80 years had a higher overall mortality rate than those aged <70 years. B: Kaplan-Meier curve illustrating stroke-related survival relative to age. There was no significant difference in stroke-related mortality among the three age groups studied.

• 

  Fig. 2 A: Kaplan-Meier curve illustrating overall survival in the patients stratified according to surgical risk: high and low. The high-risk group had a higher overall mortality than the low-risk group. B: Kaplan-Meier curve illustrating stroke-related survival in the two surgical risk groups. There was no significant difference in stroke-related mortality between the two groups.

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