Carotid endarterectomy is the surgical removal of harmful plaque from the carotid arteries in the neck. It's been shown in major clinical studies to reduce stroke occurrence in people with symptomatic carotid artery stenosis, which is blockage of these arteries. However, these studies didn't include people 80 years and older.
Some physicians doubt the benefit of operating on patients this old, perhaps due to uncertainty of the life expectancy of elderly patients with significant artery disease, says lead author Paul E. Norman, M.D., an associate professor at the School of Surgery and Pathology, University of Western Australia.
Researchers analyzed records of all patients in the area who had undergone carotid endarterectomy from 1988 to 1998. This included 1,796 people, 151 of whom were age 80 or older.
They found that the five-year survival rate for those 80 or older was 64.9 percent, compared to 80.1 percent among patients younger than 80. However, compared to a matched population in age and other factors outside the study, the relative survival at five years was 118 percent (18 percent better) for those aged 80 years or older, compared to 95 percent (5 percent worse) for those younger. Another interesting finding was that among the 1 percent of people in the study who suffered nonfatal strokes within 30 days after having the surgery, none were octogenarians or older.
The researchers conclude that the risk of death after surgery was not increased in older patients and the "likelihood of living long enough to gain benefit from carotid endarterectomy was not jeopardized by being too old."
Co-authors are James B. Semmens, Ph.D.; Crystal L. Laurvick, M.P.H.; and Michael Lawrence-Brown, M.D.
Editor's note: For more information on stroke, visit the American Stroke Association Web site: strokeassociation.org.
NR03-1091 (Stroke/Norman)
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