CAROTID-ARTERY SURGERY IN THE OCTOGENARIAN

Background: The value of carotid surgery is largely dependent on the s afety of the procedure. With changes in population life expectancy, in creasing numbers of elderly patients are being considered for surgery. Methods: In the present paper, the results of 113 patients (octogenar ians: >80 years of age) who underwent carotid endarterectomy in the 17 years prior to 1994 are reported. This group composed 6.2% of the 181 8 patients treated in the period, 665 (36.6%) operations were performe d on patients 50-65 years inclusive and 1040 (57.2%) on patients aged 66-80 years inclusive. Results: The overall peri-operative stroke rate was 2.5% and the postoperative mortality was 1.9% with no statistical difference apparent between the age groups despite hemispheric stroke s being the most common indication for operation of the octogenarian g roup (29.5%) and the least common indication in the youngest age group (16.2%, P < 0.001). Long-term follow up (2-7 years) of octogenarian p atients undergoing carotid surgery suggested maintenance of pre-operat ive levels of living independence. Conclusions: The results of the stu dy indicated that octogenarian patients should not be denied carotid e ndarterectomy on the basis of age alone and that results comparable to those of younger patients can be anticipated.