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.