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Title: Study Finds Carotid Endarterectomy Safe in Elders
URL: http://www.pslgroup.com/dg/22E89E.htm
Doctor's Guide
October 10, 2008

CHICAGO -- October 10, 2008 -- New research published in the October issue of Journal of the American College of Surgeons challenges the current opinion that patients in their eighties, who are often deemed high-risk due to their advanced age, should not undergo carotid endarterectomy.

"Age alone should not place patients in the high-risk category for carotid endarterectomy," said study authors Steven Katz, MD, Huntington Hospital, Pasadena, California, and Amy Bremner, MD, Keck School of Medicine, Los Angeles, California.

"As the elderly population surges, it is crucial to identify strategies that can potentially limit the devastating consequences of stroke and its impact on the healthcare budget. Our study shows that carotid endarterectomy remains the treatment of choice in patients 80 years of age and older with substantial blockage of the carotid arteries."

The retrospective study analysed the outcomes of 103 carotid endarterectomies in 95 patients aged 80 to 94 years (59 men, 36 women; mean age 83.7 years).

Indications for operation included symptomatic carotid stenosis in 44 patients (43%) and asymptomatic carotid stenosis in 59 (57%). Associated risk factors included diabetes (17%), hypertension (76%), coronary artery disease (28%), hyperlipidaemia (39%), and history of smoking (42%).

Results of the study showed a low incidence of neurologic complications, with only 1 transient ischaemic attack (0.97%), 2 minor strokes (1.94%), and 1 major stroke (0.97%). There were no deaths within 30 days of operation, and the combined stroke and death rate was 2.91%.

"Carotid endarterectomy remains the gold standard for treatment of extracranial carotid disease in all age groups," the authors wrote.

SOURCE: Weber Shandwick Worldwide

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