Reconstruction for lower limb occlusive disease in the elderly

Objectives: To determine the acceptability of performing distal limb bypass for occlusive vascular disease in the over 75's. Method: Patients undergoing surgery between January 1988 and December 1996 were included. Data were obtained from a card system, operating ledgers, admission diaries and hospital notes. Results: A total of 166 patients were identified. There were 69 women and 97 men, 79 were aged 75-79 years, 81 were 80-89 years and six older than 90 years, A total of 171 procedures were performed: infrainguinal bypass in 131 (77%), aorto-femoral bifurcation grafts in 10 (6%) and extra-anatomic bypass in 30 (17%). This represents 28.1% of all reconstructions for occlusive disease during this time. Nine patients (5.4%) died within 30 days and one (0.6%) required a major amputation. During the follow-up period (median 12 months), 14 major and 10 minor amputations were required. Ten patients underwent a second successful reconstructive procedure. Conclusion: Reconstruction in this group of older patients can be carried out with acceptable 30-day mortality and limb salvage rates. (C) 1998 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.