Carotid Reconstruction in Nonagenarians: Is Surgery a Viable Option?

Killeen, Kelly L.; Wagner, Willis H.; Cossman, David V.; Cohen, Jordan L.; Rao, Rajeev K.; Woo, Karen

doi:10.1016/j.avsg.2007.12.001

Cited by 6 publications

(2 citation statements)

References 23 publications

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“…Some studies have evaluated the feasibility and safety of many cardiac surgical procedures [20][21][22] and vascular interventions, particularly the repair of aneurysms and carotid endarterectomies [62][63][64][65][66][67][68][69][70][71][72][73]. Concerning the treatment of abdominal aortic aneurysms (AAA), it has been shown that endovascular repair (EVAR) is associated with lower perioperative morbidity and mortality compared to open surgery for abdominal aortic aneurysm (AAA) in a patient population aged less than 90 years [62].…”

Section: Surgical Treatment Of Nonagenarian Patientsmentioning

confidence: 99%

General management of nonagenarian patients: a review of the literature

Rivoirard¹,

Chargari²,

Trone³

et al. 2014

Swiss Med Wkly

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The number of nonagenarian people in the world is steadily growing. This phenomenon will increase in future years: in 2050, world population prospects estimate 71.16 million people aged 90 years or older. The two main causes of death among people aged 85 years or more in Europe in 2003 were cardiovascular and cerebrovascular diseases and cancers. However, the elderly are often excluded from clinical trials; they are underrepresented in clinical registries and especially nonagenarians. Care (medical, surgical, oncology) of these very elderly is currently insufficiently based on scientific recommendations. For the physician, the choice to treat or not to treat very elderly patients (for fear of side effects) is difficult. Oncology is particularly affected by this problem. Here we review these different fields of internal medicine management of nonagenarian patients with a special focus on oncology and on comprehensive geriatric assessment as a base for all care decision taking.

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Section: Surgical Treatment Of Nonagenarian Patientsmentioning

confidence: 99%

General management of nonagenarian patients: a review of the literature

Rivoirard¹,

Chargari²,

Trone³

et al. 2014

Swiss Med Wkly

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“…Surgical or endovascular treatment of carotid artery disease may be indicated for symptomatic stenosis in some cases. 22 There are several limitations to our analysis. This is a retrospective review evaluating a series of patients at a large referral center.…”

Section: Discussionmentioning

confidence: 99%

Incidental findings on cranial imaging in nonagenarians

Al-Holou

Khan²,

Wilson³

et al. 2011

FOC

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Object The aim of this article was to report on the nature and prevalence of incidental imaging findings in a consecutive series of patients older than 90 years of age who underwent intracranial imaging for any reason. Methods The authors retrospectively reviewed the electronic medical and imaging records of consecutive patients who underwent brain MR imaging at a single institution over a 153-month interval and were at least 90 but less than 100 years of age at the time of the imaging study. The prevalence of lesions by type in this consecutive series of MR imaging evaluations was calculated for all patients. The authors reviewed the medical record to evaluate whether a change in management was recommended based on MR imaging findings. They evaluated patient age at the time of death and the time interval between MR imaging and death. Results The authors identified 177 patients who met the study criteria. The group included 119 women (67%) and 58 (33%) men. Their mean age was 92.3 ± 1.8 years. Evidence of acute ischemic changes or cerebrovascular accident (CVA) was found in 36 patients (20%). Fifteen patients (8%) had an intracranial tumor. Intracranial aneurysms were incidentally identified in 6 patients (3%). Chronic subdural hematomas were found in 3 patients (2%). Overall, 25 patients (14%) had some change in medical management as a result of the MR imaging findings. The most common MR imaging finding that resulted in a change in medical management was an acute CVA (p < 0.0001). The mean time to death from date of MR imaging was 2.5 ± 2.3 years. Conclusions Intracranial imaging is rarely performed in patients older than 90 years. In cases of suspected stroke, MR imaging findings may influence treatment decisions. Brain MR imaging studies ordered for other indications in this age group rarely influence treatment decisions. Incidentally discovered lesions in this age group are generally not treated.