The results of surgical treatment of geriatric patients with atherosclerotic lesions of the brachiocephalic arteries

Аdvancements in medicine over recent decades, encompassing both therapeutic and diagnostic fields, have led to an increasing proportion of elderly individuals within the general population. As a consequence, there has been a rise in the frequency of medical consultations among this demographic. Nevertheless, contemporary literature reveals that the outcomes of surgical intervention in patients with atherosclerotic lesions of the peripheral arteries, specifically concerning the extracranial segments of the carotid arteries, remain under-explored. The aim of this study is to determine the impact of patient age on surgical treatment outcomes for individuals with atherosclerotic involvement of the carotid arteries. Material and Methods. This study assessed the treatment results of 63 patients who received surgical treatment at the Petrovsky сenter for Surgery. The cohort included both male and female patients (28 males and 35 females), age of over 75 years. All patients presented with hemodynamically significant symptomatic stenosis of the carotid arteries. The study results were derived from a retrospective analysis of a database. Results. Early postoperative outcomes (intraoperative; during the first 7–10 days post-surgery, while patients were hospitalized); and long-term postoperative outcomes (evaluated at six months post-operation). During the intraoperative period, complications developed in two patients: one case (1.56%) of non-ST elevation myocardial infarction (resolved without subsequent myocardial damage as confirmed by follow-up investigations) and one case (1.56%) of ischemic stroke. We reviewed existing literature regarding the frequency and types of major complications following carotid endarterectomy, finding no statistically significant differences relative to our findings (p > 0.05). At the six-month follow-up mark, 37 patients were assessed. Long-term outcome evaluations recorded the occurrence of non-ST elevation myocardial infarction, ischemic stroke, worsening of arterial hypertension, and mortality rates. One fatal outcome was recorded, as well as a progression of arterial hypertension in 8 patients, determined by increased frequency and dosage of antihypertensive medications. Conclusions. 1. The surgical outcomes for patients over the age of 75 with atherosclerotic lesions of the carotid arteries do not differ significantly from younger patients. 2. The presence of comorbid conditions and the severity of the patient’s initial state are the main predictive factors for the occurrence of complications. 3. Advanced age should not be regarded as a contraindication for surgical intervention.

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