The elderly patient with severe arterial insufficiency of the lower extremity: limb salvage by femoro-popliteal reconstruction.
To determine the feasibility of limb salvage in elderly patients in whom severe ischemia of the lower extremity is present, the results of femoro-popliteal reconstruction done primarily for limb salvage were reviewed. Of 310 femoro-popliteal bypasses, 72 were performed on patients 70 years of age or older. In the over-70 group, ischemic necrosis was present in 70.8% rest pain in 22.2%, and claudication in 7.0%. Initial limb salvage patients 70 years of age or older was 71.4%. Cumulative limb salvage at 5 years was 51.1% and at 10 years was 44.8%. Operative mortality, including mortality of subsequent amputation, when required, was 8.3%. Appreciable limb salvage can be achieved by femoro-popliteal arterial reconstruction in lieu of primary amputation in elderly patients in whom severe arterial insufficiency of the lower extremity is present.
D000367:Age Factors; D000368:Aged; D000671:Amputation, Surgical / Q000401:mortality; D001161:Arteriosclerosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000601:surgery; D007511:Ischemia / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011859:Radiography; D012189:Retrospective Studies; D012501:Saphenous Vein; D014182:Transplantation, Autologous; D014680:Veins / Q000637:transplantation*