title: Acute limb ischemia in nonagenarians.
abstract: OBJECTIVE
  Acute limb ischemia (ALI) is not infrequently associated with limb loss (10-30%) or death of the affected patient (15-30%). These results can be even worse in elderly population. The aim of this study is to quantify safety and efficacy of early revascularization in over 90 years old patients with acute limb ischemia.
  
  
  METHODS
  This is a prospective registry lasting from January 2012 to January 2013. We include all consecutive over 90 years patients treated for ALI (N.=15). A careful preoperative Duplex scan (DS) were performed in each patient. All patients underwent surgery by Fogarty's embolectomy, and endovascular completion procedure if needed (N.=3).
  
  
  RESULTS
  We performed 18 revascularizations (15 lower limbs, 3 upper limbs) in 15 patients (2 staged bilateral femoral, 1 simultaneous bilateral femoral). The mean follow-up was 124 days (4-365). Technical success was obtained in 16 cases (88.9%). At disharge mortality was 5.9% (1 case), and amputation rate was 6.2% (1 pt). The Kaplan-Meier curves at 1 year revealed an estimated freedom from death, amputation and re-occlusion of 76.5%, 88.2%, and 71.3%, respectively.
  
  
  CONCLUSIONS
  The over 90 years old patient represent a challenging case for vascular surgeon. Vascular procedures involve high mortality rate but emergent revascularization by Fogarty Embolectomy in ALI is safe and effective even in older patient.
authors.affiliation: Department of Medical, Surgical and Neurosciences Unit of Vascular and Endovascular Surgery University of Siena, Siena, Italy. galzerano.giuseppe@gmail.com
authors.forename: G
authors.initials: G
authors.lastname: Galzerano
authors.forename: G
authors.initials: G
authors.lastname: de Donato
authors.forename: F
authors.initials: F
authors.lastname: Setacci
authors.forename: P
authors.initials: P
authors.lastname: Sirignano
authors.forename: L
authors.initials: L
authors.lastname: Sauro
authors.forename: A
authors.initials: A
authors.lastname: Cappelli
authors.forename: C
authors.initials: C
authors.lastname: Setacci
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D018572:Disease-Free Survival; D017128:Embolectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency