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Vascular operations in nonagenarians
K M Jain1, E J Simoni, J S Munn
1Michigan State University, Kalamazoo Center for Medical Studies, USA.
Annals of Vascular Surgery
|January 1, 1996
Summary
Vascular surgery in patients aged 90+ is feasible. Careful planning and patient selection yield acceptable outcomes, including good survival and limb salvage rates for elective procedures.
Area of Science:
- Geriatric Surgery
- Vascular Surgery
- Surgical Outcomes
Background:
- Advanced age presents unique challenges in vascular surgery.
- Limited data exists on the outcomes of vascular procedures in nonagenarians.
Purpose of the Study:
- To evaluate the safety and efficacy of vascular surgical procedures in patients aged 90 years or older.
- To assess short-term and long-term outcomes, including mortality, morbidity, and limb salvage.
Main Methods:
- Retrospective review of vascular surgical procedures performed in patients aged 90 years and above.
- Analysis of 34 procedures (major/minor reconstruction, amputation) in 20 patients.
- Evaluation of 30-day mortality, 24-month survival, and limb salvage rates.
Main Results:
- A 30-day mortality rate of 6% was observed for planned surgical procedures.
- 24-month survival rate was 82% for elective major revascularizations.
- Limb salvage rate was 80% in patients undergoing elective major revascularizations.
Conclusions:
- Vascular reconstruction in nonagenarian patients can be performed with acceptable morbidity and mortality.
- Careful pre-operative planning and patient selection are crucial for successful outcomes.
- Elective major revascularization offers favorable survival and limb salvage in this elderly cohort.