Is Age of 80 Years a Threshold for Carotid Revascularization?
Author Information
Author(s): Boudewijn L van Reichmann, Guus W. Moll, Frans L de Borst, Gert J.
Primary Institution: University Medical Centre Utrecht
Hypothesis
Should age above 80 years be an upper limit for indicating carotid revascularization?
Conclusion
Carotid Endarterectomy (CEA) can be safely performed in octogenarians with complication rates comparable to younger patients, while Carotid Angioplasty and Stenting (CAS) shows higher complication rates.
Supporting Evidence
- MAE rates after CEA in octogenarians are comparable with results from younger patients.
- Higher complication rates are described for CAS in octogenarians.
- Age > 80 years is not an absolute cutoff for carotid surgery.
Takeaway
Doctors can safely perform carotid surgery on patients over 80 years old, but they should be careful with a less invasive option called stenting, which has more risks.
Methodology
A systematic review of literature from January 2000 to June 2010 was conducted to evaluate outcomes of carotid revascularization in octogenarians.
Potential Biases
Potential bias due to exclusion of octogenarians from many trials and variability in study quality.
Limitations
The review focused only on octogenarians, potentially excluding relevant data on younger elderly populations.
Participant Demographics
Included 2,963 patients undergoing CAS and 14,365 patients undergoing CEA, primarily octogenarians.
Digital Object Identifier (DOI)
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