Carotis-chirurgie beim 80-jahrigen oder alteren patienten

Background and objective: Because of their high age and markedly increased co-morbidity, physicians and geriatricians are often cautious in their indications for carotid thrombarterectomy (TEA) in patients 80 years or older. However, it is these very patients who are subject to an exponentially increased risk of ischaemic cerabral vascular accidents (CVA). This study examined the morbidity and mortality rates of TEA in patients of this age group at one institution. Patients and methods: Between 1994 and 1998, among a total of 912 TEAs, 46 had been performed in patients 80 years or older (15 women, 31 men): indications, diagnosis and associated diseases as well as perioperative complications were entered prospectively into a data-bank. Results: Only one patient (2.2%) sustained a perioperative CVA and no patient died. Three patients (6.5%) developed transitory neurological deficits. One patient had to have an emergency reoperation because of a postoperative carotid artery thrombosis. One patient had an intraoperative asystole due to a hypersensitive carotid sinus. There were no other serious cardiovascular or pulmonary complications. One patient sustained some oral muscle weakness as a result of intraoperative retractor pull on a branch of the facial muscle. Conclusion: These results indicate that even in patients of this age group carotid TEA can be performed with great safety.