The role of carotid surgery in prevention of stroke in frail elderly patients.

摘要

Between 1970 and 2002, the age-standardized death rate from all causes in the United States decreased by 32%, with the greatest reduction in deaths from cerebrovascular disease and stroke (63%) and heart disease (53%). Despite this decrease in overall age-standardized deaths, the absolute number of deaths from stroke and heart disease continue to increase, although these deaths occur at a later age.1 In the American Heart Association Heart Disease and Stroke Statistics update, the estimated direct and indirect costs of stroke for 2006 was dollar57.9 billion.2 The increased longevity of the population, combined with the higher incidence of acute cerebrovascular events in the elderly, makes prevention and management of stroke and stroke risks important goals of our national healthcare system. Aggressive stroke risk factor management, combined with appropriate surgical intervention for carotid stenosis, can significantly improve not just the longevity, but also the useful life expectancy, of the elderly population.