Carotid artery surgery in the octogenarian

Background: The value of carotid surgery is largely dependent on the safety of the procedure. With changes in population life expectancy, increasing numbers of elderly patients are being considered for surgery. Methods: In the present paper, the results of 113 patients (octogenarians: >80 years of age) who underwent carotid endarterectomy in the 17 years prior to 1994 are reported. This group composed 6.2% of the 1818 patients treated in the period, 665 (36.6%) operations were performed on patients 50-65 years inclusive and 1040 (57.2%) on patients aged 66-80 years inclusive. Results: The overall peri-operative stroke rate was 2.5% and the postoperative mortality was 1.9% with no statistical difference apparent between the age groups despite hemispheric strokes being the most common indication for operation of the octogenarian group (29.5%) and the least common indication in the youngest age group (16.2%, P < 0.001). Long-term follow up (2-7 years) of octogenarian patients undergoing carotid surgery suggested maintenance of pre-operative levels of living independence. Conclusions: The results of the study indicated that octogenarian patients should not be denied carotid endarterectomy on the basis of age alone and that results comparable to those of younger patients can be anticipated.