Surgical pathology of aorta and arteries of the lower limbs in the elderly.
From 1.1.1988 tot 31.8.1991, 42 surgical revascularisations of the aorta and the lower limbs were performed on patients aged 75 and more (men: 24--women: 18; extreme ages: 75-84; average age: 80). In all cases surgery was absolutely indicated: for advanced arteriopathy in the lower limbs (stage III or IV of Fontaine's classification) (37 cases) and ruptured abdominal aortic aneurysm (5 cases). No primary major amputation was performed in the peripheral vascular group stages III and IV. Peripheral vascular occlusive disease (30 cases) was operated under locoregional anaesthesia and consisted of the femoro-distal popliteal bypass with in situ saphenous vein (23 cases). Patients with proximal lesions preferably underwent an extra-anatomic bypass under general anaesthesia (7 cases). Ruptured infrarenal aortic aneurysm also needs a general anesthesia and represents a high surgical risk (5 cases). For the 42 patients, we observed 38 good immediate functional results and 4 peri-operative deaths. Of the 38 immediate good results, we observed 6 secondary obliterations of the bypass within a period of 5 to 18 months, among which 2 were successfully disobliterated. The other 4 patients underwent lower limb amputation.
Lurquin
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Department of Surgery, Hôpital Français Reine Elisabeth, Free University of Brussel.
Mendes da Costa
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PR
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001018:Aortic Diseases / Q000145:classification / Q000453:epidemiology* / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000145:classification / Q000453:epidemiology* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000401:mortality / Q000639:trends*