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Related Experiment Videos

[Arteritis in aged patients].

J M Cormier, H Firouzabadie, F Gigou

    Journal De Chirurgie
    |May 1, 1975
    PubMed
    Summary
    This summary is machine-generated.

    Elderly patients with peripheral vascular disease and gangrene often require surgical intervention. Despite challenges, reconstructive surgery and medical management can preserve limbs and mobility, improving patient outcomes.

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    Area of Science:

    • Vascular Surgery
    • Geriatric Medicine
    • Cardiology

    Context:

    • Gangrene is a common surgical admission reason for elderly patients with peripheral vascular disease.
    • Arterial obstruction, often in the profunda femoris or leg arteries, is typical, limiting reconstructive options.
    • Trauma or infection can precipitate gangrene in feet with otherwise healthy skin.

    Purpose:

    • To evaluate surgical and medical management strategies for gangrene in elderly patients with peripheral vascular disease.
    • To assess the efficacy of reconstructive vascular surgery, bypass procedures, and conservative treatments.
    • To analyze short-term and long-term mortality and functional outcomes in this patient cohort.

    Summary:

    • Reconstructive vascular surgery, though rarely possible, offers the best chance for healing trophic disorders with minimal toe removal.

    Related Experiment Videos

  • Axillo-femoral or femoro-femoral bypass procedures showed no failures.
  • Medical management combined with lumbar sympathectomy can conserve weight-bearing areas in select patients.
  • Low mortality (<7%) is achievable with appropriate patient selection and surgical techniques (e.g., subcutaneous bypass).
  • Long-term mortality (>20% within 6 months) is often due to cardiac, cerebral, or urinary complications.

    • Impact:

    • Successful limb salvage and preservation of weight-bearing areas were achieved in 75 out of 80 survivors (beyond 6 months).
    • Amputation was necessary in 9 cases, but 8 were below-the-knee, allowing for ambulation.
    • These functional results support aggressive limb-sparing strategies, including below-knee amputations when necessary.
    • Comprehensive management including physiotherapy and early discharge with home nursing is crucial for recovery.