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Published on: September 22, 2020

Infrapopliteal bypass reduces amputation incidence in elderly patients: a population-based study

E Eskelinen1, M Luther, A Eskelinen

  • 1Department of Vascular Surgery, Helsinki University Central Hospital, Finland and Cardiovascular Unit, Surgical Department, Vaasa Central Hospital, Finland.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|June 24, 2003
PubMed

Insights

Infrapopliteal bypass surgery for critical limb ischaemia (CLI) in older adults may reduce major amputations. This study found a lower amputation rate in hospitals performing more bypass procedures, particularly in those aged 80 and above.

Area of Science:

  • Vascular Surgery
  • Geriatric Medicine
  • Public Health

Background:

  • Critical limb ischaemia (CLI) poses a significant risk for major amputation in elderly populations.
  • Treatment strategies for CLI aim to preserve limb viability and reduce amputation rates.

Purpose of the Study:

  • To investigate the relationship between infrapopliteal bypass surgery rates and major amputation incidence in Finnish individuals aged 70 years and older.
  • To compare amputation rates in hospitals with high versus low rates of performing infrapopliteal bypass procedures.

Main Methods:

  • Retrospective analysis of patients undergoing infrapopliteal bypass or major amputation for CLI in 1997.
  • Comparison of major amputation incidence between hospitals categorized as 'active' or 'passive' in performing infrapopliteal bypass.

Main Results:

  • The incidence of major amputations was significantly lower in the 'active' bypass group (1976 per million) compared to the 'passive' group (3177 per million).
  • A significant inverse relationship between bypass and amputation rates was observed in patients aged 80 years and older, but not in younger age groups.

Conclusions:

  • Infrapopliteal bypass surgery appears to be an effective intervention for reducing the need for major amputation in elderly patients (aged >=80) with CLI.
  • The findings support a strategy of increased utilization of infrapopliteal bypass to improve limb salvage outcomes in this vulnerable population.
Abstract

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