Prior studies have suggested that young patients may be more prone to recur
rent disease after carotid endarterectomy (CEA). The goal of this study was
to review a series of CEAs performed on younger patients (less than or equ
al to 55 years) and to determine if these patients are more likely to devel
op recurrent stenosis. A review was conducted of CEAs performed from 1985 t
hrough 1994. Analysis was performed on a study group of 94 young patients w
ho underwent 109 CEAs during this time. A control group of 222 patients old
er than 55 years who underwent 256 CEAs during the years 1991 through 1993
was selected for comparison. During a mean of nearly 4 years of follow-up,
younger patients were significantly more likely to experience a late failur
e of CEA, including total occlusion of the operated artery, or recurrent st
enosis requiring redo surgery. Careful patient evaluation is important in c
hoosing younger patients who require CEA. Implications of these data includ
e mandating careful noninvasive follow-up examinations for younger patients
undergoing CEA.