CT and Histological Findings and Treatment Outcomes after Carotid Endarterectomy for Symptomatic Cervical Carotid Artery Stenosis in Octogenarians Kojiro WADA 1 , Hirohiko ARIMOTO 2 , Naoki OOTANI 1 , Hideo OSADA 1 , Arata TOMIYAMA 1 , Satoshi TOMURA 1 , Hideo UENO 1 , Kazuya FUJII 1 , Kimihiro NAGATANI 1 , Satoru TAKEUCHI 1 , Kentaro MORI 1 1Department of Neurosurgery, National Defense Medical College 2Department of Neurosurgery, Japan Defense Forces Central Hospital Keyword: atherosclerosis , carotid endarterectomy , carotid artery stenosis , pathology , plaque pp.1118-1124
Published Date 2014/12/10
DOI https://doi.org/10.11477/mf.1436200046
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 Symptomatic cervical carotid artery stenosis is one of the common causes of ischemic stroke in octogenarians. The records for 90 consecutive patients with symptomatic cervical carotid artery stenosis treated by carotid endarterectomy(CEA)were analyzed retrospectively. The patients were divided into two groups:21 patients aged 80 years or over and 69 patients aged less than 80 years. CT angiography revealed that ulcer formation was significantly more common and the length of carotid artery stenosis was significantly greater in the octogenarians. Histological examination of the plaque revealed no significant difference between the two groups in terms of ulcer formation, lipid content, and intraplaque hemorrhage. However, all three of these pathological findings were present in a significantly higher number of octogenarians. No significant difference was observed for new ischemic lesions on diffusion-weighted MR imaging, neurological complications, or cardiac and pulmonary complications. However, treatment with an albumin preparation and loop diuretics was significantly more common in octogenarians after CEA. The present study suggests that with careful postoperative management CEA can be safely performed in symptomatic patients aged 80 years or over with almost the same risk as that for patients aged less than 80 years.

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