[Endovascular revascularization for lower extremity atherosclerosis obliterans in elderly patients:a report of 86 cases].
OBJECTIVE
To analyze the outcome and risk factors of endovascular revascularization of lower limb artery for elder patients.


METHODS
From January 2006 to November 2008, 86 elder patients (98 ischemia limbs) underwent endovascular revascularization due to lower limb ischemia. Age of this group were 60 to 82 years old with a mean of (70 +/- 6) years old. Fifty-four limbs (55.0%) had severe intermittent claudication, 28 limbs (28.6%) had rest pain, 11 limbs (11.2%) had ulcer, and 5 limbs (5.1%) had gangrene. Sixty-six limbs were mono segment disease, including 25 aorta-iliac lesions, 33 femoral-popliteal lesions and 8 infra-popliteal lesions. Thirty-two limbs were multiple segment disease involving 2 or 3 segment lesions. Mortality, morbidity, primary patency, secondary patency and limb salvage were retrospectively analyzed. Risk factors on outcome were also evaluated.


RESULTS
Ten limbs underwent angioplasty, while the rest 88 limbs underwent angioplasty plus primary stent implantation. The total operation success rate was 95.9%. Perioperative mortality within the first 30 d was 0. Perioperative morbidity within the first 30 d was 5 cases (5.1%), including 2 myocardial infarction, 2 major amputations and 1 irreversible contrast-induced nephropathy. Follow-up duration were 1 to 35 months with a mean of (18 +/- 10) months. Eighty-three (96.5%) patients had effectively follow-up. Mortality was 2.3% (2 cases died due to myocardial infarction). Primary patency rate was 83.7%, secondary patency rate was 94.9% and limb salvage rate was 95.9%. Risk factor analysis showed that diabetes mellitus, critical ischemia and multiple segment lesions were associated with worse patency.


CONCLUSIONS
Endovascular treatment is effective, safe and repeatable revascularization for elder patients of Critical lower limb ischemia. Patients with diabetes mellitus, critical ischemia and multiple segment lesions should be paid more attention because their rather worse outcome.
Ye
Wei
W
Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Liu
Chang-wei
CW
Li
Yong-jun
YJ
Zheng
Yue-hong
YH
Wu
Ji-dong
JD
Liu
Bao
B
Zeng
Rong
R
Wu
Wei-wei
WW
Song
Xiao-jun
XJ
Guan
Heng
H
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001162:Arteriosclerosis Obliterans / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome