Carotid endarterectomy in octogenarians

Abstract

BACKGROUND: The role of carotid endarterectomy in octogenarians is unclear as this age group was not included in the major trials of carotid surgery. The aim of the present study was to determine the trends and early outcome of carotid endarterectomy performed in octogenarians at a single institution. METHODS: A retrospective review of all carotid endarterectomies performed between 1990 and 2001 was conducted as part of a clinical audit. Trends in procedure numbers, length of stay, age and early outcome were assessed. The results of octogenarians were analysed separately. RESULTS: Three hundred and fifty-nine carotid endarterectomies were performed in 329 patients including 33 octogenarians. The number of cases and the mean age of patients increased and length of stay decreased during the study period. There was a significant increase in the proportion of octogenarians undergoing carotid endarterectomy (P = 0.03) in the second half of the study period. The combined rate of stroke and death was higher in octogenarians compared with patients under 80 years old, but the difference was not statistically significant (8.8%vs 5.8%; P = 0.59). CONCLUSION: The mean age of patients and the proportion of octogenarians undergoing carotid endarterectomy has increased over the 12-year study period.