Complications after peripheral vascular interventions in octogenarians.
OBJECTIVE
To investigate the incidence of complications after peripheral vascular interventions in patients aged 80 years and older compared to patients below the age of 80.


METHODS
During a 20-month period, 619 consecutive patients (354 men; mean age 67 years, range 59-87) undergoing balloon angioplasty and stenting for lower limb revascularization were enrolled in the study. The incidence of procedure-related, access-site, and major complications within 30 days post intervention were recorded and compared between patients aged 80 years and older (n=72, 11.6%) and those under 80 years of age.


RESULTS
Complication rates were significantly higher in octogenarians compared to patients below 80 years, including the rates of overall complications (18.1% versus 8.5%, p=0.010), major complications (11.1% versus 1.8%, p<0.001), all access site complications (12.5% versus 4.9%, p=0.009), and access site bleeding complications (12.5% versus 2.2%, p<0.001). By multivariable analysis, octogenarians had a 2.49-fold increased adjusted risk (95% CI 1.10 to 5.65, p=0.029) for any postintervention complication and a 10.99-fold increased adjusted risk (95% CI 2.76 to 45.74, p=0.001) for major complications compared to patients below 80 years. No specific risk factor for complications or major complications within the octogenarian population could be identified.


CONCLUSIONS
Patients aged 80 years and older have a dramatically increased risk, particularly for major complications, after peripheral vascular interventions. Identification of risk factors and development of preventive strategies are urgently needed to improve procedure safety in this extremely vulnerable population.
Dick
Petra
P
Department of Angiology, Medical University Vienna, Austria.
Barth
Borner
B
Mlekusch
Wolfgang
W
Sabeti
Schila
S
Amighi
Jasmin
J
Schlager
Oliver
O
Koppensteiner
Renate
R
Minar
Erich
E
Schillinger
Martin
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015607:Stents / Q000009:adverse effects*