Carotid endarterectomy in young adults: Is it a worthwhile procedure?
| Autor: | Andrea Mingoli, Claudio Modini, Luca di Marzo, Paolo Sapienza, Giovanna Sgarzini, Antonino Cavallaro, Richard J. Feldhaus, C Burchi |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Carotid arteries Carotid endarterectomy Disease-Free Survival Postoperative Complications Risk Factors medicine Humans Carotid Stenosis Young adult Endarterectomy Carotid business.industry Incidence (epidemiology) Mortality rate Age Factors Middle Aged medicine.disease Surgery Stenosis Cerebrovascular Disorders Postoperative mortality Ischemic Attack Transient Female High incidence business Cardiology and Cardiovascular Medicine Follow-Up Studies |
| Zdroj: | Journal of Vascular Surgery. 25(3):464-470 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/s0741-5214(97)70256-8 |
| Popis: | Purpose: The aim of the study was to investigate surgical indication and long-term outcome of carotid endarterectomy (CE) in young adults.Methods: Between 1973 and 1990, 1693 patients underwent CE. Forty-nine patients (group 1) 35 to 45 years of age who had carotid artery stenosis greater than 70%, formed the basis for the analysis. They were compared with two additional groups of patients older than 45 years of age selected from the entire series. Group 2 was randomly chosen to determine differences in risk factors, associated diseases, operative indications, preoperative findings, and outcome. Group 3 was matched with patients in group 1 for sex, risk factors, associated diseases, preoperative findings, and operative indications to assess the importance of age in determining the short- and long-term outcome of CE.Results: Postoperative mortality, cerebrovascular accidents, and cardiac complications in patients of group 1 (2%, 2%, and 2%, respectively) were similar to those of the other groups ( p = NS). During the follow-up (76.7 ± 3.6 months; range, 1 to 120 months) the incidence of strokes and transient ischemic attacks in group 1 was lower than in group 2 ( p < 0.05) but similar to group 3 ( p = NS). Ten-year disease-free intervals were 75.7%, 58.7%, and 77.6%, respectively, for groups 1, 2, and 3. Mortality rate unrelated to cerebrovascular disease was similar between group 1 and group 3 ( p = NS) but was higher in group 1 than in group 2 ( p < 0.02). Ten-year survival rates were 46.1%, 71.7%, and 55.5%, respectively, for group 1, 2, and 3.Conclusions: CE in patients younger than 45 years of age is a safe procedure with low operative risks and good disease-free intervals. However, life expectancy is poor because of the high incidence of deaths resulting from complications of atherosclerosis.(J Vasc Surg 1997;25:464-70.) |
| Databáze: | OpenAIRE |
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