Carotid endarterectomy in patients 55 years of age and younger

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.