[Surgical management of elderly and senile patients with critical lower extremity ischemia]

This paper describes an experience with examination and surgical treatment of 194 elderly (60-74 years); and senile (75 years and more) patients with critical lower extremity ischemia (CLEI) of atherosclerotic genesis. The patient group examined was marked by multiple coexistent pathology (primarily cardial)), appreciably increasing the risk of surgical intervention. The patients of both groups were provided altogether 345 operations. Because of remarkable concomitant pathology and compromised distal bed the greater part of patients underwent little traumatic non-reconstructive operations (56.5%); in many cases (41.3%), the necessary scope of intervention was divided into stages. On analysis of the results account was taken of the limited potential of performing in geriatric patients of prolonged operations as well as of the way of life of the overwhelming majority of old-group patients. The results were evaluated according to the scale suggested by the authors. The indicated treatment policy allowed to reach, the beneficial results in 80.1% of patients in the immediate period. In the long-term period (6 to 60 months), the positive results turned out stable in more than 70% of patients. This allows to recommend the approaches worked out for use in clinical practice for the treatment of geriatric patients presenting with CLEI.