Biomedical subjects

R Chiesa

Publications and source records attributed to R Chiesa.

At least 19 recordsLinked to original sources

PubMed2007

Results of endografting of the aortic arch in different landing zones.

INTRODUCTION: Endovascular approach to the aortic arch is an appealing solution for selected patients. Aim of this study is to compare the technical and clinical success recorded in the different anatomical settings of endografting for aortic arch disease. METHODS: Between June 1999 and October 2006, among 178 patients treated at our Institution for thoracic aorta disease with a stent-graft, the aortic arch was involved in 64 cases. According to the classification proposed by Ishimaru, aortic "zone 0" was involved in 14 cases, "zone 1" in 12 cases and "zone 2" in 38 cases. A hybrid surgical procedure of supraortic debranching and revascularization was performed in 37 cases to obtain an adequate proximal aortic landing zone. RESULTS: "Zone 0" (14 cases). Proximal neck length: 44+/-6mm. Initial clinical success 78.6%: 2 deaths (stroke), 1 type Ia endoleak. At a mean follow-up of 16.4+/-11 months the midterm clinical success was 85.7%. "Zone 1" (12 cases). Proximal neck length: 28+/-5mm. Initial clinical success 66.7%: 0 deaths, 4 type Ia endoleaks. At a mean follow-up of 16.9+/-17.2 months the midterm clinical success was 75.0%. "Zone 2" (38 cases) Proximal neck length: 30+/-5mm. Initial clinical success 84.2%: 2 deaths (1 cardiac arrest, 1 multiorgan embolization), 3 type Ia endoleaks, 1 case of open conversion. Two cases of delayed transitory paraparesis/paraplegia were observed. At a mean follow-up of 28.0+/-17.2 months the midterm clinical success was 89.5%. CONCLUSIONS: Total debranching of the arch for "zone 0" aneurysms allowed to obtain a longer proximal aortic landing zone with lower incidence of endoleak, however a higher risk of cerebrovascular accident was observed. The relatively high incidence of adverse events in "zone 1" could be associated to a shorter proximal neck, therefore this landing zone is reserved for patients unfit for sternotomy. In case of endoleak, discovered after a satisfactorily positioned endograft in the arch, the rate of spontaneous resolution within the first 6 months is high.

Adult↗

PubMed2006

A new chemical etching process to improve endosseous implant osseointegration: in vitro evaluation on human osteoblast-like cells.

The development of novel mechanical and chemical surface modification treatments to improve the osteointegration properties of osseointegrated dental implants is nowadays a topic of great applicative interest. The aim of the present study was to analyse the role of surface topography and chemistry of four different surface treatments on titanium by an in vitro human osteosarcoma immortalised cell line model (MG63). The surface treatments considered were (a) machined titanium, (b) chemical etched on machined titanium, (c) sandblasted titanium and (d) chemical etching on sandblasted titanium. Chemical and physical surface properties were investigated by Scanning Electron Microscopy, Thin Film-X ray Diffraction and by Laser Profilometry. The in vitro biological response was characterised using the MG63 cell line by elution cytotoxicity tests, cell morphology, adhesion, proliferation activity, alkaline phosphatase activity and total DNA content in order to show a relationship between osteoblast response and surface features. Chemical and physical characterisation showed that the considered treatments differently modify the surface morphology in the micro and sub-micrometric scale. Although some differences in alkaline phosphatase activity were observed in the biological characterisation, depending on the specific material's surface finishing, the results showed that cells were well responsive on all the tested materials and grew and differentiated with similar proliferation rate.

Air Abrasion, Dental↗

PubMed2006

Tribological characterization of surface-treated commercially pure titanium for femoral heads in total hip replacement: a feasibility study.

Most noncemented total hip replacements combine a titanium alloy stem, a CoCrMo femoral head and an ultra-high molecular weight polyethylene (UHMWPE) acetabular cup. In spite of its nickel content of up to 1% and the resulting biocompatibility issues in some clinical situations, the higher cost and some difficulties in machining, CoCrMo alloy is preferred to titanium alloys thanks to its outstanding tribological properties, higher hardness and elastic modulus. Nowadays most of the heads of hip prostheses use CoCrMo as bearing material. The present study investigates the effect of various surface treatments and combinations of treatments, such as electrochemical oxidation (anodization), laser surface melting and barrel polishing, on the tribological properties of commercially pure grade 2 titanium. The aim of the study was to characterize surface treatments capable of improving the tribological properties of titanium surface to the same extent as CoCrMo. The tribological properties were characterized by multidirectional pin-on-flat screening wear tests, using UHMWPE pins as bearing surface. The experiments showed the possibility of improving the wear resistance of titanium to the degree of CoCrMo. Although further efforts will be required to optimize the treatments studied, the results are encouraging enough to warrant pursuing this direction of investigation.

Arthroplasty, Replacement, Hip↗

PubMed2006

Surface roughness of three resin restorative materials after finishing and polishing.

AIM: The surface roughness of 3 different resin restorative materials polymerized with a halogen and a plasma arc curing light, following finishing and polishing was evaluated in vitro. METHODS: Using a metal mold, 10 block specimens were prepared from each material. A Mylar strip was placed on both sides of the mold. Five specimens from each material were cured with the halogen lamp, while the other 5 were polymerized with the plasma arc lamp. In both groups the surface exposed to curing light was finished and polished with the Enhance system (Dentsply). The opposite surface was not treated and served as a control. Both surfaces of each specimen were analyzed with a laser profilometer: the roughness average (R(a)) was evaluated. The Vickers microhardness of the polished surfaces was also calculated. All data were statistically analyzed with the Mann-Whitney test. A regression test was carried out to evaluate the possible correlation between roughness and microhardness. RESULTS: The smoothest surfaces were obtained when composites were cured against a Mylar strip. Roughness was significantly increased in both groups in the treated surfaces. A significant correlation between roughness and microhardness could not be demonstrated. CONCLUSIONS: This study demonstrated that the surface polymerized against a Mylar strip was the smoothest surface produced, while the roughness of the Mylar-formed surface was significantly increased by finishing and polishing. Surface roughness following polishing is material-dependent.

Composite Resins↗

PubMed2005

Electroencephalographic background desynchronization during cerebral blood flow reduction.

OBJECTIVE: The aim of this study is to evaluate the usefulness of a spectral function detecting cerebral hypoperfusion. METHODS: Continuous electroencephalographic monitoring was employed during 47 consecutive carotid endarterectomies. Patients were assigned to 3 different groups according to the entity of electroencephalographic changes during carotid clamping (major changes: group A; moderate changes: group B; no change: group C). The desynchronization function, indicating the reduction of the 8-15 Hz band power, and the desynchronization index were calculated. RESULTS: Group A function decreased within 20s from clamping, with a constant slope (7.14). Desynchronization indexes were: 76.85% (group A), 40.23% (group B) and 15.29% (group C). Difference among groups was statistically significant (P < 0.0001). A case of syncope due to asystole is also reported, showing the same pattern in the descending phase of the function. CONCLUSIONS: The stereotyped time course of the desynchronization function describes the cerebral reaction to significant blood flow reduction. Values of desynchronization index exceeding 65% seem to correctly detect patients with cerebral hypoxic risk. SIGNIFICANCE: The analysis of the 8-15 Hz band desynchronization is helpful in the evaluation of cerebral hypoperfusion during carotid endarterectomy. This method could be employed in monitoring different clinical situations of ischemia.

Aged↗

PubMed2005

Electrochemical release testing of nickel-titanium orthodontic wires in artificial saliva using thin layer activation.

Alloys based on Ni-Ti intermetallics generally exhibit special shape memory and pseudoelastic properties, which make them desirable for use in the dental field as orthodontic wires. The possibility of nickel release from these materials is of high concern, because the allergenicity of this element. The aim of this study was to test pseudoelastic Ni-Ti wires in simulated physiological conditions, investigating the combined effect of strain and fluoridated media: the wires were examined both under strained (5% tensile strain) and unstrained conditions, in fluoridated artificial saliva at 37 degrees C. Real time electrochemical nickel release testing was performed using a novel application of a radiotracer based method, thin layer activation (TLA). TLA was validated, in unstrained conditions, against adsorptive stripping voltammetry methodology. Control tests were also performed in non-fluoridated artificial saliva. From our research it transpired that the corrosion behaviour of Ni-Ti alloy is highly affected by the fluoride content, showing a release of 4.79+/-0.10 microg/cm2/day, but, differently from other biomaterials, it does not seem to be affected by elastic tensile strain. The application of the TLA method in the biomedical field appears a suitable technique to monitor in real time the corrosion behaviour of biomedical devices.

Biomimetic Materials↗

PubMed2005

Demographic factors and their relationship with the presence of CVI signs in Italy: the 24-cities cohort study.

BACKGROUND: Chronic venous insufficiency (CVI) is a common progressive disease, the deterioration rate depending on specific risk factors. Demographic characteristics associated with the prevalence of objective signs of CVI were evaluated in a cross-sectional population study in Italy. METHODS: A sample of 5247 people selected by advertising in television and newspapers in 24 Italian cities underwent a clinical examination of the lower limbs, including colour-coded duplex ultrasonography, to determine the presence and severity of CVI. Of these, 4288 subjects provided demographic data that could be analysed by multiple logistic regression model using sex, age, region and family history as covariates. RESULTS: Women were four or more times as likely as men to develop telangiectasia, whilst males had a two-fold increased risk of trunk varices. Age was the main risk factor for vein varicosis in the female population, with women aged over 50 years being almost five times as likely as those aged 29 or less to show trunk varices. Females living in the southern regions had a two-fold increase in risk of developing CVI signs and the risk increased by at least 1.3 times in multiparous women. A positive familial history of disease increased the risk for varicose veins. CONCLUSIONS: Demographic characters such as sex, advanced age, living in the southern regions, number of pregnancies and a family history of CVI were all contributing risk factors for the development of CVI in Italy.

Adolescent↗

PubMed2005

Single center experience with a new commercially available thoracic endovascular graft.

PURPOSE: To evaluate the intra-operative performance and clinical outcome of a new commercially available stent-graft for the treatment of thoracic aortic diseases. METHODS AND PATIENTS: From January 2003 to October 2004, 45 consecutive patients received endovascular treatment with the Zenith TX1 device for diseases of the thoracic aorta at a single center in northern Italy. Indications included disease of the descending thoracic aorta in 26 cases, of the aortic arch in 17 cases and of the thoraco-abdominal aorta in two cases. We treated 38 atherosclerotic aneurysms, two post-traumatic aortic ruptures, two penetrating ulcers, two chronic dissections and one case was treated for aortic bleeding after voluntary acid ingestion for attempted suicide. General anesthesia was used in 20 cases. Combined or hybrid endovascular and open surgical repair was performed in 11 patients. Mean follow-up was 7 months (range 1-22 months). RESULTS: Technical success was obtained in 44 patients (98%). One primary type I endoleak occurred (2%). ICU was used in 12 cases with a mean stay of 1 day. The mean hospital stay was 6 days (range 4-13 days). There were no hospital deaths or strokes but one transient paraplegia (2%). A type II endoleak was observed in one case and resolved spontaneously 1 month later. No aneurysm enlargement, endograft migration or structural failures were observed during follow-up. Two late unrelated-deaths were observed. CONCLUSIONS: This stent-graft does not fulfill all the characteristics of the ideal graft, however, it proved to be safe and allowed satisfactory short term results in this group of patients treated at a single center.

Adolescent↗

PubMed2005

Visceral artery aneurysms.

Visceral artery aneurysms (VAA) frequently present as life-threatening emergencies. The purpose of this study was to review our experience with VAA treatment. Between 1988 and April 2002, 31 VAA were treated in 28 patients (14 males, 14 females) with average age of 55 +/- 15 years. The most common locations were the splenic artery (16) and the hepatic artery (7). Three patients underwent emergency surgery, 22 patients had elective open surgery, and 7 patients underwent endovascular treatment. In the surgical group the perioperative mortality rate was 3.6%. The perioperative morbidity rate was 7.1% (one case of respiratory distress manifested in the immediate postoperative period and one urgent case of bilious fistula). In the endovascular group none of the patients died; the perioperative morbidity rate was of 14.3% (one case of hepatic artery thrombosis after failure of gastroduodenal artery aneurysm embolization). Failure of the procedure was 42.9% (3 cases of aneurysm recanalization). In conclusion, we believe that an aggressive surgical approach is justified, even in the case of asymptomatic VAA, because of the low morbidity and mortality rates. Endovascular treatment should be reserved for selected cases.

Abdomen↗

PubMed2005

Endovascular treatment of aortic arch aneurysms.

INTRODUCTION: The aim of this study was to review our clinical experience with endovascular treatment of aortic arch aneurysms using different commercially available grafts (Gore, Talent, Endomed, Cook). METHODS: From 1999 to 2004, 97 patients received endovascular treatment for diseases of the thoracic aorta. In 30 cases (26 males, 4 females) the aortic arch was involved. The left subclavian artery was overstented (Ishimaru zone '2') in 18 cases (60%). Only in the first three cases had the subclavian artery been revascularized. The left common and subclavian arteries were covered (zone '1') in 6 (20%) cases-all had the carotid artery reconstructed, either simultaneously (five cases) or as a staged procedure (one case). Finally, the whole aortic arch was over-stented (zone '0') in 6 (20%) cases, with simultaneous (five cases) or staged (one case) grafting of the supra-aortic vessels from the ascending aorta. RESULTS: Perioperative mortality was 2/30 (7%), due to graft migration (zone '2') and intra-operative stroke (zone '0'), respectively. One minor stroke was observed. No cases of paraplegia were recorded. Three type I endoleaks were observed. Two resolved at 6 months follow-up; one zone '0' graft is still being followed. There was one surgical conversion for endograft failure 2 weeks after implantation. Thus, the technical success rate was 87% (26/30) cases. The mean follow-up time was 23+/-17 months. No new onset endoleaks or aneurysm-related deaths were recorded. CONCLUSIONS: Currently available grafts may be deployed in the aortic arch in most instances. De-branching of the aortic arch with surgical revascularization for zone '0' and '1' seems to be adequate to obtain a satisfactory proximal landing zone.

Aged↗

PubMed2005

Fate of the visceral aortic patch after thoracoabdominal aortic repair.

OBJECTIVE: To analyse the fate of a visceral aortic patch (VAP) in patients that underwent thoracoabdominal aortic aneurysm (TAAA) repair. METHODS: We reviewed 204 consecutive patients (158 M, 46 F) treated for TAAA between 1988 and 2004. We performed VAP in 182 cases. Among the 149 survivors at 6 months, we followed 138 cases, mean follow-up 7 years (range 0.6-16 years). The mean graft diameter we used was 29mm (range 24-34mm) from 1988 to 1999 (83 patients), and 21.7mm (range 16-24mm) from 2000 to 2003 (55 patients). In 23% of cases we performed a separate bypass to the left renal artery. RESULTS: We observed 16 (12%) VAP dilatations (<5cm), 6 (4%) VAP aneurysms (>5cm) and one VAP pseudoaneurysm, at a mean time of 6 years after atherosclerotic TAAA was atherosclerotic repair. There were no VAP dilatations/aneurysms in the group of patients with separate left renal revascularization. Five VAP aneurysms were treated electively. In four cases the operation was performed with thoracophrenolaparotomy, in one case with a bilateral subcostal laparotomy. In all cases the visceral aorta was re-grafted. Reimplantation of a single undersized VAP was performed in one case, separate revascularization of visceral arteries was performed in the other four cases. Selective intraoperative hypothermic perfusion of visceral and renal arteries was used in all the patients. There was 1 perioperative death; 2 patients with preoperative renal failure required dialysis. The last VAP aneurysm has remained asymptomatic and stable at annual CT surveillance. The VAP pseudoaneurysm was successfully treated with an emergency thoracophrenolaparotomy and refashioning the left side suture line. CONCLUSIONS: Aneurysm of VAP is not uncommon in the patients operated on using larger grafts with a single VAP that includes the LRA (7.4%, 5/67 cases). Its treatment carries significant morbidity and mortality.

Aged↗

PubMed2005

Chronic venous insufficiency in Italy: the 24-cities cohort study.

OBJECTIVE: To assess the relationship between sex, age, geographical region, lower limb symptoms and the presence of trunk varicose veins and venous incompetence. DESIGN: Cross-sectional population study in 24 cities in the North, centre and South of Italy. PARTICIPANTS: Five thousand two hundred and forty-seven people were selected during spring and summer 2003 by advertising on television, in newspapers, and by leaflets in 24 Italian cities. In all 5187 (4457 [85.9%] women and 730 men [14.1%]) volunteers were assessed. The median age was 54 (range: 18-90) years for the women and 61 (range: 18-89) years for the men. METHODS: Self-administered questionnaire on subjective symptoms of chronic venous insufficiency (CVI) in the lower limbs, and clinical examination, including colour duplex ultrasonography to assess the presence and severity of varicose veins. RESULTS: Overall only 22.7% of the subjects examined were free of visible signs of venous disease, with approximately 53% of the population over 50 years of age showing some venous reflux. People living in Southern Italy were more severely affected than those living in the North. Varicosities and telangiectases were the most frequent objective signs in both sexes. Trunk varicosities (27%) and saphenous reflux (41%) increased with age and were more common in men; in contrast, minor objective symptoms such as telangiectases (70%), as well as subjective symptoms such as heavy (79%) and tired legs (78%), were more common in women and were not age-related. CONCLUSIONS: Venous disease is very common in Italy, in particular in people living in the South. A correlation between varicose veins and venous incompetence is more marked in men, while minor objective and subjective symptoms prevail in women. The findings from this non-random sample closely match results from previous studies, in which random sampling was used.

Adolescent↗

PubMed2005

Soft tissue response to a new austenitic stainless steel with a negligible nickel content.

This study evaluates the soft tissue response to a new austenitic stainless steel with a low nickel content (P558) in comparison with a conventional stainless steel (SSt)and a titanium alloy (Ti6Al4V). Previous findings showed its in vitro biocompatibility by culturing P558 with healthy and osteoporotic osteoblasts and its in vivo effectiveness as bone implant material. Regarding its use as a material in osteosynthesis,P558 biocompatibility when implanted in soft tissues, as subcutis and muscle, was assessed. Disks and rods of these metals were implanted in rat subcutis and in rabbit muscle, respectively. Four and twelve weeks post surgery implants with surrounding tissue were retrieved for histologic and histomorphometric analysis: fibrous capsule thickness and new vessel formation were measured. Around all implanted materials, light microscopy highlighted a reactive and fibrous capsule formation coupled with ongoing neoangiogenesis both in rats and in rabbits. Histomorphometric measurements revealed a stronger inflammatory response,in terms of capsule thickness,surrounding SSt implants (9.8% Ni content) both in rat subcutis and in rabbit muscle independently of shape and site of implantation. A progressive decrease in capsule thickness around P558 (<0.02% Ni content) and Ti6Al4V, respectively, was seen. Regarding new vessel density, the data showed a different response dependent on the site of implantation. However,in the light of the previous and present studies, P558 is a good material, instead of titanium alloys, in orthopedic research.

Animals↗

PubMed2004

A new austenitic stainless steel with a negligible amount of nickel: an in vitro study in view of its clinical application in osteoporotic bone.

A biomaterial named P558 is a new austenitic stainless steel (SS) with a negligible amount of Ni (<0.20%). In previous in vitro and in vivo studies it was compared with conventional SS and Ti6Al4V and shown to be a promising material in orthopedics. Because osteoporosis is a type of pathology very often encountered in implanted patients and can be studied with in vitro models, the purpose of the present study was to evaluate P558 in vitro through comparison of normal (nOB) with osteopenic (oOB) bone-derived primary rat osteoblasts. Osteoblasts were cultured directly on P558 and polystyrene as controls for 72 h. Osteoblast proliferation, adhesion, and activity (ALP, OC, TGF-beta1, and IL-6) were evaluated at 24 and 72 h. Results demonstrated that the growth of nOB and oOB cultured on P558 was not affected negatively when compared to control. Cells on P558 did not show any alteration in terms of adhesion, proliferation, and metabolic marker production in nOB and oOB cultures, and a significant increase in ALP, OC, and TGF-beta1 production was observed. SEM images revealed no alteration in cell morphology. The current findings demonstrate that P558 promotes osteoblast proliferation, activation, and differentiation not only in normal bone, but also in osteopenic bone-derived osteoblasts.

Biocompatible Materials↗

PubMed2003

Histomorphometric and microhardness assessments of sheep cortical bone surrounding titanium implants with different surface treatments.

Several factors influence the healing process and the long-term mechanical stability of cementless fixed implants, such as bone remodeling and mineralization processes. Histomorphometric and bone hardness measurements were taken in implants inserted in sheep femoral cortical bone at different times to compare the in vivo osseointegration of titanium screws (diam.; 3.5 x 7 mm length) with the following surface treatments: machined (Ti-MA); acid-etched (Ti-HF); HA vacuum plasma spray (Ti-HA); and Ca-P anodization followed by a hydrothermal treatment (Ti-AM/HA). Ti-MA and Ti-AM/HA implants presented the lowest (Ra = 0.20 +/- 0.01 microm) and highest (Ra = 1.97 +/- 0.64 microm) significant (p < 0.0005) roughness value, respectively. Bone-to-implant contact of Ti-HF was lower than that of the other surface treatments at both experimental times (8 weeks: -20%, ns; 12 weeks: -30%, p < 0.01). Significant differences in MAR (mineral apposition rate) were also found between the different experimental times for Ti-MA (115%, p < 0.01) and Ti-HF (57%, p < 0.01), demonstrating that bone growth had slowed inside the screw threads of Ti-HA and Ti-AM/HA after 12 weeks. No bone microhardness changes in preexisting host bone were found, while Ti-MA showed the lowest value for the inner thread area at 8 weeks (HV(200 microm)= 49.8 +/- 3.8 HV). These findings confirm that osseointegration may be accelerated by adequate surface roughness and bioactive ceramic coating such as Ca-P anodization followed by a hydrothermal treatment, which enhance bone interlocking and mineralization.

Animals↗

PubMed2003

A new austenitic stainless steel with negligible nickel content: an in vitro and in vivo comparative investigation.

New nickel (Ni)-reduced stainless-steel metals have recently been developed to avoid sensitivity to Ni. In the present study, an austenitic Ni-reduced SSt named P558 (P558, Böhler, Milan, Italy) was studied in vitro on primary osteoblasts and in vivo after bone implantation in the sheep tibia, and was compared to ISO 5832-9 SSt (SSt) and Ti6Al4V. Cells were cultured directly on P558 and Ti6Al4V. Cells cultured on polystyrene were used as controls. Osteoblast proliferation, viability and synthetic activity were evaluated at 72 h by assaying WST1, alkaline phosphatase activity (ALP), nitric oxide, pro-collagen I (PICP), osteocalcin (OC), transforming growth factor-beta1 (TGFbeta-1) and interleukin-6 (IL-6) after 1.25(OH)2D3 stimulation. Under general anaesthesia, four sheep were submitted for bilateral tibial implantation of P558, SSt and Ti6Al4V rods. In vitro results demonstrated that the effect of P558 on osteoblast viability, PICP, TGF beta-1, tumor necrosis factor-alpha production did not significantly differ from that exerted by Ti6Al4V and controls. Furthermore, P558 enhanced osteoblast differentiation, as confirmed by ALP and OC levels, and reduced IL-6 production. At 26 weeks, the bone-to-implant contact was higher in P558 than in SSt (28%, p<0.005) and Ti6Al4V (4%, p<0.05), and was higher in Ti6Al4V than in SSt (22%, p<0.005). The tested materials did not affect bone microhardness in pre-existing host bone as evidenced by the measurements taken at 1000 microm from the bone-biomaterial interface (F=1.89, ns). At the bone-biomaterial interface the lowest HV value was found for SSt, whereas no differences in HV were observed between materials (F=1.55, ns). The current findings demonstrate P558 biocompatibility both in vitro and in vivo, and osteointegration processes are shown to be significantly improved by P558 as compared to the other materials tested.

Alloys↗

PubMed2003

Hzf-3 expression in the amygdala after establishment of conditioned taste aversion.

We studied the regulation of the expression of the inducible orphan nuclear receptor known as HZF-3 (or Nurr1) in acquisition of conditioned taste aversion in rats. Our results show that HZF-3 expression in the lateral/basolateral (LA/BLA) amygdala complex was significantly up-regulated when both the conditioned and the unconditioned stimuli were paired, but not when either of the stimuli was presented alone. Induction in the LA/BLA had a faster onset than induction in the central nucleus of the amygdala. The results implicate HZF-3 in the acquisition of associative aversive experiences.

Amygdala↗

PubMed2003

Carotid endarterectomy in the octogenarian: outcomes of 345 procedures performed from 1995-2000.

The purpose of this study is to evaluate the efficacy and the safety of carotid endarterectomy (CEA) in the octogenarian patient. From January 1995 to December 2000, we have performed 3430 CEAs in 2743 patients: 345 CEAs in 269 octogenarian patients (Group 1) and 3085 CEAs in 2474 younger patients (Group 2). Age was the only selection criteria for including patients in Group 1. Octogenarians' perioperative mortality (1.4%) was greater than that in Group 2 (0.3%) (p<0.05). No differences can be found between the groups' perioperative ipsilateral stroke rates (1.7% in Group 1 vs 1.2% in Group 2) and combined ipsilateral stroke and death rates (2.3% in Group 1 vs 1.3% in Group 2) (p>0.05). The octogenarians' Kaplan-Meier 6-year overall and free-stroke survival rates were 86 and 76% respectively. CEA can be performed in selected octogenarian patients with low early and late mortality and neurologic morbidity rates.

Age Factors↗