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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
14:58

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

Atherosclerosis in the younger patient. Results of surgical management

W E Evans, J P Hayes, B D Vermillion

    American Journal of Surgery
    |August 1, 1987
    PubMed

    Insights

    Younger patients under 50 with atherosclerosis show better survival rates than older patients. Smoking is a key risk factor for this younger demographic with peripheral vascular disease.

    Area of Science:

    • Vascular Surgery
    • Cardiovascular Research
    • Epidemiology of Atherosclerosis

    Background:

    • Atherosclerosis commonly affects older populations.
    • Limited data exists on the long-term outcomes of atherosclerosis in patients under 50 years of age.
    • Understanding risk factors and outcomes in younger individuals is crucial for targeted interventions.

    Purpose of the Study:

    • To compare the clinical characteristics, surgical outcomes, and long-term survival of patients under 50 with atherosclerosis to those over 50.
    • To identify significant risk factors for atherosclerotic peripheral vascular disease in younger patients.

    Main Methods:

    • Retrospective review of hospital and office records for 153 patients under 50 with atherosclerosis.
    • Analysis of risk factors, surgical procedures (aortofemoral bypass, femoropopliteal bypass, femorotibial bypass), postoperative course, and long-term results.
    • Comparison of data with a cohort of patients over 50 years of age.

    Main Results:

    • Patients under 50 demonstrated superior survival rates compared to patients over 50.
    • Survival in the younger cohort was comparable to the general population up to 5 years.
    • Limb salvage rates were similar for aortofemoral and femoropopliteal bypasses in both age groups.
    • Femorotibial bypass had lower limb salvage rates in patients under 50 compared to older patients.
    • Smoking was identified as the most significant risk factor in patients under 50.

    Conclusions:

    • Atherosclerosis in patients under 50 does not appear to be more virulent than in older patients.
    • Younger patients with atherosclerosis have favorable long-term survival, especially in the first 5 years.
    • While certain bypass procedures show similar limb salvage, femorotibial bypass outcomes are poorer in younger individuals.
    • Smoking cessation interventions are critical for managing atherosclerotic peripheral vascular disease in patients under 50.

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