[Percutaneous transluminal angioplasty of the lower extremities in the elderly]

Results of percutaneous transluminal angioplasty (PTA) for peripheral arterial occlusion were compared between a group of 41 patients aged over 60 years and one of 39 patients under 60 years. In the older patients the proportion of those in a decompensated state was 61%, more than double that in the younger ones. 54% of the older patients were diabetics with a poor peripheral vascular outflow bed; conservative treatment failed in them and surgical intervention was not possible. A primary success rate of PTA was 87% in the older patients, no worse than in the younger ones. Long-term follow up of both groups indicated that PTA in the compensated stage achieved prolongation of pain-free walking distance or absence of symptoms in 74%. Threatened leg amputation could be avoided in 80% of the younger and 60% of the older patients. Limited amputation was performed in 20% of the older patients with decompensated vascular disorders. The most frequent complication of PTA was embolization into the small vessels of the lower leg, in nearly 30% of patients. But only once did this worsen the clinical state, and this was transitory.