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. 2024 May;106(5):248-254.
doi: 10.4174/astr.2024.106.5.248. Epub 2024 Apr 30.

Outcomes of carotid endarterectomy in octogenarians compared to their younger counterparts: a retrospective observational study

Joon-Kee Park  1 , Shin-Seok Yang  1 , Dong-Ik Kim  1 , Young-Wook Kim  2 , Da-Hyun Kim  1 , Yang-Jin Park  1
Affiliations

Outcomes of carotid endarterectomy in octogenarians compared to their younger counterparts: a retrospective observational study

Joon-Kee Park et al. Ann Surg Treat Res. 2024 May.

Abstract

Purpose: This study was performed to analyze the association between age and outcomes of carotid endarterectomy (CEA) by comparing postoperative outcomes between octogenarians and younger patients.

Methods: From November 1994 to December 2022, 1,585 internal carotid arteries of 1,434 patients were enrolled. Patients were stratified into 2 groups: octogenarians (≥80 years old) and non-octogenarians (<80 years old). Primary endpoints were early (≤30 days) outcomes of ipsilateral stroke, any stroke, myocardial infarction, death, and major adverse cardiovascular events (MACE). We also compared overall any stroke and death between the 2 groups.

Results: One of 132 octogenarians (0.8%) and 17 of 1,453 non-octogenarians (1.1%) experienced ipsilateral stroke within 30 days. Thirty-day MACE occurred in 4 of 132 octogenarians (3%) and 44 of 1,453 non-octogenarians (3%). There were no significant differences in any early (≤30 days) outcomes. Symptomatic status was associated with increased 30-day MACE (odds ratio [OR], 2.610; 95% confidence interval [CI], 1.450-4.696; P = 0.003) and 30-day any stroke (OR, 3.999; 95% CI, 1.627-9.828; P = 0.003). Symptomatic status was also associated with overall any stroke (hazard ratio [HR], 2.885; 95% CI, 1.865-4.463; P < 0.001), but age of ≥80 years was not associated with 30-day MACE, 30-day any stroke, or overall stroke. Age of ≥80 years was only associated with overall survival (HR, 2.644; 95% CI, 1.967-3.555; P < 0.001).

Conclusion: CEA would be a safe and effective treatment for octogenarians with low 30-day complications and long-term stroke rates, comparable with that of younger counterparts. Advanced age is not a contraindication for CEA.

Keywords: Aged; Carotid endarterectomy; Carotid stenosis; Treatment outcome.

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Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. The Kaplan-Meier survival curve of the freedom from stroke rates in octogenarians and non-octogenarians who underwent carotid endarterectomy.
Fig. 2
Fig. 2. The Kaplan-Meier survival curve of the overall survival in octogenarians and non-octogenarians who underwent carotid endarterectomy.
See this image and copyright information in PMC

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