Methods: We have evaluated the results of carotid surgery in 252 patients of 75 years and over age (A group) including 281 interventions between June 1st 1985 and December 31st 1993.
Results: These results have been compared to those obtained in 660 patients of less 75 years (B group), operated on over the same period of time (741 interventions). In the A group, the mean age was 78.2 (from 75 to 89) and 37.3% were women. Nicotinism, obesity and dyslipaemia was significantly more frequent in A group. An angor was shown in 48% in A group (versus 38.8% in B group). In A group, 34.5% (n = 97) of patients were neurologically asymptomatic against 41.7% (n = 309) in B group. Four patients aged over 75 died (1.42% per intervention), one from myocardial infarction, the other from postoperative stroke. Three other patients showed a non regressive postoperative neurological deficiency. The Cumulated Rate of Mortality Morbidity (CRMM) in A group is then 2.49% per intervention. It does not significantly differ from B group results: mortality = 1.48% (n = 11, 10 of neurological origin), CRMM = 3.23% per intervention. We counted 4 myocardial infarctions (1.58%) in A group and 5 (0.75%) in B group. The mean time after the interventions was 58 months. The five years actuarial survival is 73% of A group patients and 85% for B group patients. In A group patients, 44% of deaths are of coronary origin and 35% in B group patients. The actuarial rate of people free from neurological deficiency, after 5 years, is 90.9% in A group and 92.4% in B group.
Conclusions: In this study, age does not seem to be a risk factor in carotid surgery. The elderly patients must be selected according to the same criteria as the under 75, save the estimation of intellectual faculties and autonomy.