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Reconstruction for lower limb occlusive disease in the elderly
J J Smith1, G J Toogood, R B Galland
1Department of Surgery, Royal Berkshire Hospital, Reading, UK.
Cardiovascular Surgery (London, England)
|March 12, 1999
Summary
Distal limb bypass surgery for occlusive vascular disease is acceptable in patients over 75. This study found acceptable 30-day mortality and limb salvage rates in this elderly population.
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Cardiovascular Research
Background:
- Occlusive vascular disease frequently affects elderly individuals.
- Surgical interventions for limb salvage are critical in this demographic.
- The safety and efficacy of distal limb bypass in octogenarians require evaluation.
Purpose of the Study:
- To assess the acceptability of distal limb bypass procedures.
- To evaluate outcomes in patients aged 75 and older undergoing vascular reconstruction.
- To determine 30-day mortality and limb salvage rates in this specific patient group.
Main Methods:
- Retrospective analysis of 166 patients aged 75 and over.
- Data collected from January 1988 to December 1996.
- Included infrainguinal bypass, aorto-femoral grafts, and extra-anatomic bypass procedures.
Main Results:
- 171 procedures were performed, with infrainguinal bypass being most common (77%).
- 30-day mortality was 5.4% (9 patients), with one major amputation (0.6%).
- Median follow-up of 12 months showed 14 major and 10 minor amputations; 10 patients had successful secondary reconstructive procedures.
Conclusions:
- Distal limb bypass for occlusive vascular disease is a viable option for patients over 75.
- Reconstructive surgery in this elderly cohort demonstrates acceptable mortality and limb salvage rates.
- The findings support the continued use of vascular reconstruction in older adults with critical limb ischemia.