| Carotid Endarterectomy in Eldery Patients: Experience of 21 Cases |
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In-Kyeong Kim , Sang Hyung Lee , Young-Je Son , Young Seob Chung |
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Department of Neurosurgery, Seoul National University Colloege of Medicine, Seoul, Korea |
| 노인 환자에서의 경동맥 내막 절제술: 21예의 임상 경험 |
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김인경ㆍ이상형ㆍ손영제ㆍ정영섭 |
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서울대학교 의과대학 신경외과학교실 |
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| Abstract |
Background
Carotid endarterectomy (CEA) provide overwhelming benefits on stroke compared with medical therapy in preventing subsequent stroke for symptomatic or asymptomatic severe carotid stenosis. But many physicians however hesitate to refer elderly patients for CEA because of high surgical risk and limited life expectancy.
Methods
The authors analyzed restrospectively 21 CEAs in 19 patients from June 1998 to February 2009. Median age of patients was 65 years (ranged from 49 to 80 years) and male to female ratio was 15 to 4, we investigated the outcome of CEAs in patients of more than 65 years of age and their younger counterpart. The duration of follow up was 4 to 99 months (median, 26). Almost all of CEAs were done on the side of stenosis more than 80% and bilateral CEAs were done in two. One CEA was performed in asymptomatic patients.
Results
The patients over 65 years had more frequent hypertension (85.7% vs 28.6%), cardiac risk factor (28.6% vs 14.3%) and less frequent smoking (21.4% vs 100%). There was no significant difference between them for the sex, right-left ratio, preoperative symptoms, diabetes, dyslipidemia. Permanent complications occurred in 2 (14.3%) in >65 years patient only. Postoperative significant stroke was in 1 of 14 patients (7.1%) in >65 years patients.
Conclusions
Age does not seem to be a absolute contraindication for surgery in patients with symptomatic or high-grade asymptomatic carotid artery stenosis. Elderly patients cannot be per se be excluded regarding low risk patient selection putting stroke risk factors, concomitant diseases. |
| Key Words:
Carotid stenosisㆍCarotid endarterectomyㆍElderlyㆍCompliacation |
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