Young Patients Undergoing Carotid Endarterectomy Have Increased Rates of Recurrent Disease and Late Neurologic Events

• Published in: Journal of vascular surgery 2023
• Main Authors: Ratner, Molly, MD, Garg, Karan, MD, Chang, Heepeel, MD, Johnson, William, MD, Sadek, Mikel, MD, Maldonado, Thomas, MD, Cayne, Neal, MD, Siracuse, Jeffrey, MD, MBA, Jacobowitz, Glenn, MD, Rockman, Caron, MD
• Format: Article
• Language: English
• Subjects: Surgery
• ISSN: 0741-5214
• DOI: 10.1016/j.jvs.2023.02.011

AbstractObjectivesThere is a paucity of data regarding outcomes of patients with premature cerebrovascular disease (age ≤ 55 years) who undergo carotid endarterectomy (CEA). The objective of this study was to analyze the demographics, presentation, perioperative and later outcomes of younger patients undergoing CEA. MethodsThe Society for Vascular Surgery Vascular Quality Initiative was queried for CEA cases between 2012-2022. Patients were stratified based on age ≤ 55 or age > 55 years. Primary endpoints were periprocedural stroke, death, myocardial infarction and composite outcomes. Secondary endpoints included restenosis (≥80%) or occlusion, late neurologic events and re-intervention. ResultsOf 120,549 patients undergoing CEA, 7,009 (5.5%) were ≤ 55 years old (mean age of 51.3 years). Younger patients were more likely to be African American (7.7% vs 4.5%, p < .001), female (45.2% vs 38.9%, p < .001) and active smokers (57.3% vs 24.1%, p < .001). They were less likely than older patients to have hypertension (82.5% vs 89.7%, p < .001), coronary artery disease (25% vs 27.3%, p < .001) and CHF (7.8% vs 11.4%, p