title: Autonomy following revascularisation in 80-year-old patients with critical limb ischaemia.
abstract: OBJECTIVE
  We wanted to compare autonomy recovery after open and endovascular infrainguinal surgery for critical limb ischaemia (CLI) in octogenarians.
  
  
  METHODS
  We performed a retrospective analysis of 167 consecutive CLI octogenarians who underwent infrainguinal open surgery (OS) or endovascular surgery (ES) between 2003 and 2008. OS and ES groups were compared in terms of autonomy level (Parker score), survival, limb salvage and patency rates.
  
  
  RESULTS
  Preoperative autonomy level was similar in both groups (OS n = 109, ES n = 58) but 6-month postoperative autonomy level was better after ES (p = 0.01). There was a trend towards better survival after OS (74% at 1 year, 62% at 2 years, 32% at 4 years with OS and 68%, 50%, 17% respectively for ES p = 0.06), but no difference regarding limb salvage (91% at 1 year, 90% at 2 years, 89% at 4 years for OS and 94%, 87%, 86% respectively for ES, p = 0.939) and primary patency (76% at 1 year, 59% at 2 years, 50% at 4 years for OS and 82%, 75%, 32% respectively for ES, p = 0.467).
  
  
  CONCLUSIONS
  ES is justified in CLI octogenarians, because it allows restoring a higher autonomy level, with limb salvage and patency rates comparable to OS.
authors.affiliation: Department of Vascular Surgery, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Lejay
authors.forename: F
authors.initials: F
authors.lastname: Thaveau
authors.forename: Y
authors.initials: Y
authors.lastname: Georg
authors.forename: C
authors.initials: C
authors.lastname: Bajcz
authors.forename: J-G
authors.initials: JG
authors.lastname: Kretz
authors.forename: N
authors.initials: N
authors.lastname: Chakfé
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D016009:Chi-Square Distribution; D016638:Critical Illness; D004691:Endarterectomy / Q000009:adverse effects / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007511:Ischemia / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D018579:Patient Selection; D026684:Personal Autonomy; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000401:mortality; D014654:Vascular Patency