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International Young Surgeons Competition

IYSC06 - Carotid Endarterectomy in Octogenarians

Wednesday, June 14, 2023
4:05 PM – 4:12 PM ET
Objectives: The aim of the present study was to evaluate the outcome of CEA for SCAS in patients >80 year-old

Methods: This is a retrospective analysis of patients treated with CEA from 2005 to 2022 for SCAS. Patients were divided according to their age in non-octogenarian ( < 80year-old) and octogenarian (≥80 year-old) and compared for post-operative stroke/death considering also type of symptoms and the timing of intervention. Clinical visit was performed yearly during the follow-up.

Results: In the period examined 457 symptomatic patients were treated by CEA, 166 (36%) were octogenarian (mean age 84±4) and had similar preoperative characteristics of non-octogenarian except for the distribution of preoperative neurological type of symptoms: transient ischemic attack (TIA) 51% vs. 42% P=.05, amaurosis fugax (AF) 14% vs 5%, P=.001; stroke 36% vs. 53%, P=.01. The timing between symptoms and surgery was similar between the two groups 10±8 vs 8±7 days respectively, P=.22. Overall, the postoperative rate of stroke/death was similar between octogenarian and non-octogenarian: 2.4% vs. 3.1%, P=.54. Similarly, by stratifying the patients by type of preoperative symptom they did not affect the outcome between older and younger patients: TIA 2.4% vs. 3.3%, P=.63; AF 0% vs 0%, P=.1.0 and stroke 3.4% vs. 3.3%, P=1.0. The timing of CEA did not affect the rate of stroke/death: in octogenarian 3.7%, if performed within 48h, 1.6% between 2days and 14 days and 1.3%after 2 weeks, P=.72. At 5-year follow-up (mean follow-up 68±14 months) the ipsilateral stroke free survival was 97.6%± 4% with no differences between octogenarian and non-octogenarian: 95.2%±6% vs 98.1% ± 3%, P=.32.

Conclusions: SCAS octogenarian submitted to CEA have low rate of perioperative and follow-up events, comparable with not octogenarian. The timing and the type of symptoms do not seem to affect the CEA outcome