[An elderly patient with severe peripheral vascular disease]

Area of Science:

• Vascular Surgery
• Geriatric Medicine
• Palliative Care

Background:

• Peripheral arterial disease (PAD) is prevalent in the elderly.
• Severe PAD may necessitate endovascular revascularization, bypass surgery, or amputation.
• Amputation is considered when revascularization treatments are unsuccessful.

Observation:

• A 94-year-old female with dementia presented with a painful foot ulcer.
• Revascularization attempts failed, and amputation was considered due to infection.
• A conservative, palliative approach was chosen, leading to ulcer mummification.
• The patient maintained a good quality of life for 11 months post-diagnosis.

Findings:

• Conservative management of critical limb ischemia in elderly patients with dementia is feasible.
• A palliative approach can result in limb mummification without adverse effects on quality of life.
• Family-documented quality of life insights are valuable.

Implications:

• Elderly patients with severe PAD and dementia may benefit from conservative, palliative care over amputation.
• This approach can preserve quality of life and potentially delay or avoid surgical intervention.
• Healthcare providers should consider non-invasive management strategies for select elderly patients.