GW Researchers Find Carotid Endarterectomy Safe in Certain Octogenarians
The outcomes for patients in their 80s who received carotid endarterectomy (CEA) surgery to reduce the risk of stroke are comparable to those of younger patients, according to a study by George Washington University (GW) researchers published in the Journal of Vascular Surgery.
The paper’s authors include researchers in the Department of Surgery at GW Hospital, as well as GW School of Medicine and Health Sciences fourth-year medical student Brandon Glousman, who was first author on the paper.
The researchers found that although octogenarians had a slightly higher mortality than younger patients when undergoing a CEA, the risk of mortality was still low at 1.2%. CEA, according to the paper, is the gold standard to prevent a recurrent stroke in symptomatic patients with carotid stenosis, a narrowing of the carotid arteries that could lead to blood clots.
“We found that CEA is a safe procedure in appropriately selected patients in their 80s who have asymptomatic carotid stenosis,” Glousman said. “We found that overall life expectancy and preoperative functional ability, rather than age, should be a major factor in the decision to operate.”
For the research, the outcomes of 13,846 patients with asymptomatic carotid stenosis who underwent CEA, a surgical procedure to remove plaque buildup in the carotid artery, were analyzed; 2,509 of those patients were octogenarians, while 11,337 were younger individuals, whose age averaged to 68.
Looking at 30-day outcomes, the authors found that octogenarians had slightly higher mortality (1.2% vs 0.5) and a higher risk of return to the operating room (3.3% vs 2.3). However, according to the paper, there was no difference between octogenarians and younger patients in adverse cardiac events or pulmonary, renal, or wound complications.
The researchers concluded that outcomes between both patient populations were comparable and that “there was no difference between octogenarians and younger patients in adverse cardiac events or pulmonary, renal, or wound complications.”
The research paper, “Carotid endarterectomy for asymptomatic carotid stenosis is safe in octogenarians,” was published in the Journal of Vascular Surgery and can found at www.jvascsurg.org/article/S0741-5214(19)31668-4/fulltext.
