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Experimental and Clinical Cardiology, vol.20, no.7, pp.1596-1604, 2014 (Scopus)
Background: As the growing proportion of octogenarians in the ageing population may lead to a dramatic increase in cerebrovascular disease, preventing and treating stroke will be a serious challenge in the octogenarian. Objectives: We reviewed the outcome of carotid endarterectomy in the octogenarians with or without contralateral carotid stenosis or occlusion and compared the results with a similar cohort of younger age. Material and Methods: From 2005 to 2013, 142 CEAs were performed by a single surgical team on 128 patients were reviewed for early outcome in regards to hospital mortality and stroke. Results: 128 patients (111 males; mean 68.5±9.3 years-old, range 49-85) underwent CEA by the same surgical team. 14 patients had severe bilateral disease and underwent bilateral CEAs Smoking was significantly higher in the nonoctogenarians (6.2% vs. 21.8%, P<0.05). Preoperative history of transient ischemic events was the most common scenario in both octogenarians and the younger patients although preoperative transient neurologic deficits were more prominent in the non-octogenarians (50% vs. 71%, P<0.05). Contralateral carotid artery occlusion was seen in a total of 14 patients (12.5% in the octogenarians vs. 9% in the younger patients, P =0.52). Only one patient in the octogenarian group experienced a lateralizing stroke due to ipsilateral CEA in contrast to 3 patients (lateralizing stroke in 3 patients, lacunar state in one patient) in the younger patients. Conclusions: Carotid endarterectomy, despite the general perception, is a viable option for patients with CCO or bilateral disease even in the octogenarian group.