Endovascular procedures in critical leg ischemia of elderly patients.

Abstract

PURPOSE:

Purpose of this study was to evaluate angiographic and clinical results of popliteal, infrapopliteal, and multi-level disease percutaneous transluminal angioplasty (PTA) in over-80 years old patients with chronical clitical leg ischemia. In fact such patients with extensive peripheral vascular disease and critical limb ischemia (CLI) are generally poor surgical candidates.

METHODS:

Between 1998 and 2003, 37 elderly patients aged 80-89 years old (mean age 83.3) with critical leg ischemia were treated with PTA. All patients were at high surgical risk. 31/37 (81.5%) patients had chronic non-healing wounds, and 14/37 (37%) had multi-level disease of superficial femoral, popliteal and crural arteries. One hundred and two lesions were treated by angioplasty. Immediate angiographic and 1 year clinical results were retrospectively analyzed.

RESULTS:

The overall procedural success rate was 32/37 (84.2%). There were three major complications (7.9%), but no deaths, and three technical failures, all were of infrapopliteal lesions. After 1 year, 27 patients could be followed, five patients died during the first year of unrelated causes. Twenty-three patients (85.2%), were clinically re-occluded within 1 year, but complete and partial wound healing was achieved in 80% (16/20) and rest pain improvement in 57% (4/7), so that overall limb salvage was 74% (20/27).

CONCLUSIONS:

Elderly patients with multi-level CCLI have a short patency term following angioplasty of 14.8% after 1 year. Nevertheless, this temporary vascular patency enables wound healing or improvement in 74% of these patients, thus such endovascular interventions are recommended in this age group.

• Authors: B Amato, G P Iuliano, A K Markabauoi, V Piscitelli, S Masone, R Compagna, G Esposito, F Piscione
• Journal: Acta bio-medica : Atenei Parmensis (Acta Biomed) Vol. 76 Suppl 1 Pg. 11-5 ( 2005) ISSN: 0392-4203 [Print] Italy
• PMID: 16450500 (Publication Type: Journal Article)

Topics

• Aged
• Angioplasty, Balloon
• Critical Illness
• Female
• Humans
• Ischemia (therapy)
• Leg (blood supply)
• Male
• Retrospective Studies