Surgery
Volume 148, Issue 1 , Pages 119-128 , July 2010

Infrapopliteal arterial reconstructions for limb salvage in patients aged ≥80 years according to preoperative ambulatory function and residential status

  • Enzo Ballotta, MD

      Affiliations

    • Vascular Surgery Section, Geriatric Surgery Clinic, Department of Surgical and Gastroenterological Sciences, University of Padua, Padova, Italy
    • Corresponding Author InformationReprint requests: Enzo Ballotta, MD, Vascular Surgery Section, Geriatric Surgery Clinic, Department of Surgical and Gastroenterological Sciences, University of Padua, School of Medicine Via N. Giustiniani, 2 35128 Padova, Italy.
    • ,
  • Mario Gruppo, MD

      Affiliations

    • Geriatric Surgery Clinic, Department of Surgical and Gastroenterological Sciences, University of Padua, Padova, Italy
    • ,
  • Franco Mazzalai, MD

      Affiliations

    • Geriatric Surgery Clinic, Department of Surgical and Gastroenterological Sciences, University of Padua, Padova, Italy
    • ,
  • Bruno Martella, MD

      Affiliations

    • Geriatric Surgery Clinic, Department of Surgical and Gastroenterological Sciences, University of Padua, Padova, Italy
    • ,
  • Oreste Terranova, MD

      Affiliations

    • Geriatric Surgery Clinic, Department of Surgical and Gastroenterological Sciences, University of Padua, Padova, Italy
    • ,
  • Giuseppe Da Giau, MD

      Affiliations

    • Vascular Surgery Section, Geriatric Surgery Clinic, Department of Surgical and Gastroenterological Sciences, University of Padua, Padova, Italy

,Accepted 24 December 2009.

References 

  1. Arias E. United States life tables, 2004. Natl Vital Rep. 2007;(56):1–39
  2. Giannakouris K. Eurostat. Statistics in focus. Population and social conditions. Available from: http://epp.eurostat.ec.europa.eu/cache/ITY_OFFPUB/KS-SF-08-072/EN/KS-SF-08-072-EN.PDF. Accessed February 24, 2009.
  3. Kalra M, Gloviczki P, Bower TC, Panneton JM, Harmsen WS, Jenkins GD, et al. Limb salvage after successful pedal bypass grafting is associated with improved long-term survival. J Vasc Surg. 2001;33:6–16
  4. Lepantalo M, Matzke S. Outcome of unreconstructed chronic critical leg ischemia. Eur J Vasc Endovasc Surg. 1996;11:153–157
  5. Klevsgård R, Risberg BO, Thomsen MB, Hallberg IR. A 1-year follow-up quality of life study after hemodynamically successful or unsuccessful surgical revascularization of lower limb ischemia. J Vasc Surg. 2001;33:114–122
  6. Nguyen LL, Moneta GL, Conte MS, Bandyk DF, Clowes AW, Seely BL. PREVENT III Investigators. Prospective multicenter study of quality of life before and after lower extremity vein bypass in 1404 patients with critical limb ischemia. J Vasc Surg. 2006;44:977–984
  7. Edwards WH, Mulherin JL, Rogers DM. Vascular reconstruction in the octogenarian. South Med J. 1982;75:648–652
  8. Scher LA, Veith FJ, Ascer E, White RA, Samson RH, Sprayregen S, et al. Limb salvage in octogenarian and nonagenarians. Surgery. 1986;99:160–165
  9. O'Mara CS, Kilgore TL, McMullan MH, Maples MD, Hollingsworth JF, Tyler HB. Distal bypass for limb salvage in very elderly patients. Am Surg. 1987;53:66–70
  10. Cogbill TH, Landercasper J, Strutt PJ, Gundersen AL. Late results of peripheral vascular surgery in patients 80 years of age and older. Arch Surg. 1987;122:581–586
  11. Friedman SG, Kerner BA, Friedman MS, Moccio CG. Limb salvage in elderly patients. J Cardiovasc Surg (Torino). 1989;30:848–851
  12. Humphreys WY, Evans F, Watkin G, Williams T. Critical limb ischemia in patients over 80 years of age options in a district general hospital. Br J Surg. 1995;82:1361–1363
  13. Plecha FR, Bertin VJ, Plecha EJ, Avellone JC, Farrell CJ, Hertzer NR, et al. The early results of vascular surgery in patients 75 years of age and older: an analysis of 3259 cases. J Vasc Surg. 1985;2:769–774
  14. Aune S, Amundsen SR, Trippestad A. The influence of age on long-term survival pattern of patients operated on for lower limb ischemia. Eur J Vasc Endovasc Surg. 1996;12:214–217
  15. Nicoloff AD, Taylor LM, McLafferty RB, Moneta GL, Porter GM. Patient recovery after infrainguinal bypass grafting for limb salvage. J Vasc Surg. 1998;27:256–266
  16. Salas CA, Adam DJ, Papavassiliou VG, London NJ. Percutaneous transluminal angioplasty for critical limb ischaemia in octogenarians and nonagenarians. Eur J Vasc Endovasc Surg. 2004;28:142–145
  17. Brosi P, Dick F, Do DD, Schmidli J, Baumgartner I, Diehm N. Revascularization for chronic critical lower limb ischemia in octogenarians is worthwhile. J Vasc Surg. 2007;46:1198–1207
  18. Dick P, Barth B, Mlekusch W, Sabeti S, Amighi J, Schlager O, et al. Complications after peripheral vascular interventions in octogenarians. J Endovasc Ther. 2008;15:383–389
  19. Connors JP, Walsh DB, Nelson PR, Powell RJ, Fillinger MF, Zwolak RM, et al. Pedal branch artery bypass: a viable limb salvage option. J Vasc Surg. 2000;32:1071–1079
  20. Ballotta E, Renon L, De Rossi A, Barbon B, Terranova O, Da Giau G. Prospective randomized study on reversed saphenous vein infrapopliteal bypass to treat limb-threatening ischemia: common femoral artery versus superficial femoral or popliteal and tibial arteries. J Vasc Surg. 2004;40:732–740
  21. Ballotta E, Renon L, Toffano M, Piccoli A, Da Giau G. Patency and limb salvage rates after distal revascularization to unclampable calcified outflow arteries. J Vasc Surg. 2004;39:539–546
  22. Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg. 1997;26:517–538
  23. Nehler MR, Moneta GL, Edwards JM, Yeager RA, Taylor LM, Porter JM. Surgery for chronic lower extremity ischemia in patients eighty or more years of age: operative results and assessment of postoperative independence. J Vasc Surg. 1993;18:618–626
  24. Gouny P, Bertrand P, Decaix B, Hocquet-Cheynel C, Karcenty B, Chenila M, et al. Distal bypass for limb salvage: comparative study in patients below and above 80 years of age. J Cardiovasc Surg. 1994;35:419–424
  25. Hearn AT, Smith JM, Welling RE, Lohr JM, Thibodeaux LC. Analysis of autogenous vein femoral-infrapopliteal bypass for limb salvage in the elderly. Cardiovasc Surg. 1996;4:105–109
  26. Luther M, Lepantalo M. Femorotibial reconstruction for chronic critical leg ischemia: influence on outcome by diabetes, gender and age. Eur J Vasc Endovasc Surg. 1997;13:569–577
  27. Pomposelli FB, Arora S, Gibbons GW, Frykberg R, Smakowski P, Campbell DR, et al. Lower extremity arterial reconstruction in the very elderly: successful outcome preserves not only the limb but also residential status and ambulatory function. J Vasc Surg. 1998;28:215–225
  28. Chang JB, Stein TA. Infrainguinal revascularizations in octogenarians and septuagenarians. J Vasc Surg. 2001;34:133–138
  29. Eskelinen E, Luther M, Eskelinen A, Lepantalo M. Infrapopliteal bypass reduces amputation incidence in elderly patients: a population-based study. Eur J Vasc Endovasc Surg. 2003;26:65–68
  30. Taylor SM, Kalbaugh CA, Blackhurst DW, Langan EM, Cull DL, Snyder BA, et al. Postoperative outcomes according to preoperative medical and functional status after infrainguinal revascularization for critical limb ischemia in patients 80 years and older. Am Surg. 2005;71:640–646
  31. Lepantalo M, Eskelinen E. Outcome of infrapopliteal bypass in the elderly. Acta Chir Belg. 2007;107:1–7
  32. Finlayson EV, Birkmayer ID. Operative mortality with elective surgery in older adults. Eff Clin Pract. 2001;4:172–177
  33. Jin F, Chung F. Minimizing perioperative adverse events in the elderly. Br J Anaesth. 2001;87:608–624
  34. Ballotta E, Da Giau G, Gruppo M, Mazzalai F, Martella B. Infrapopliteal arterial revascularization for critical limb ischemia: is the peroneal artery at the distal third a suitable outflow vessel?. J Vasc Surg. 2008;47:952–959
  35. Ascer E, Veith FJ, Gupta SK, White SA, Bakal CW, Wengerter K, et al. Short vein grafts: a superior option for arterial reconstructions to poor or compromised outflow tracts?. J Vasc Surg. 1988;7:370–378

PII: S0039-6060(09)00830-7

doi: 10.1016/j.surg.2009.12.013

Surgery
Volume 148, Issue 1 , Pages 119-128 , July 2010

Article Tools

* Image Usage & Resolution