title: Do octogenarians still have a high risk of adverse outcomes after carotid endarterectomy in the era of a super-aged society? A single-center study in Japan.
abstract: BACKGROUND
  The aim of this study was to evaluate the safety and feasibility of carotid endarterectomy (CEA) in Japanese octogenarians.
  
  
  METHODS
  This study prospectively included 157 consecutive CEA procedures in 145 patients treated at Fukuoka University Hospital between May 2008 and April 2013. Clinical and radiologic findings were obtained from the medical records and by telephone interview. Major events and outcomes were compared between patients 80 years of age or older (octogenarians) and those less than 79 years of age (nonoctogenarians).
  
  
  RESULTS
  The rate of major adverse events (major stroke, myocardial infarction, or death) in the perioperative period was 1.2%. Follow-up data were available for 142 patients (97.9%). Only 1 case (.7%) of ipsilateral stroke occurred during the follow-up period. Thirteen patients died of causes other than stroke. The estimated 1-, 3-, and 5-year overall survival rates were 98.5%, 96.9%, and 93.1%, respectively. Nineteen (13.4%) of the patients were octogenarians. There were no significant differences in baseline characteristics between octogenarians and nonoctogenarians, except for age. In octogenarians, there were no major adverse events during the perioperative period and no cases of stroke or stroke-related death during the follow-up period. The estimated 1-, 3-, and 5-year overall survival rates in octogenarians were 92.9%, 92.9%, and 61.9%, respectively. There was no significant difference in overall survival between octogenarians and nonoctogenarians (P = .371).
  
  
  CONCLUSIONS
  The results of this study suggest that CEA can be safely performed in Japanese octogenarians. Midterm outcomes were relatively good, but long-term outcomes require further study.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. Electronic address: okawam@fukuoka-u.ac.jp.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Okawa
authors.affiliation: Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Ogata
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Abe
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Higashi
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology*; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*; D016896:Treatment Outcome
keywords: Carotid endarterectomy; elderly; long-term follow-up; octogenarian