Document Detail


Peripheral arterial disease in octogenarians and nonagenarians: factors predicting survival.
MedLine Citation:
PMID:  20926240     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: To describe the prevalence and character of complications associated with revascularization procedures as a result of peripheral arterial disease in octogenarians and nonagenarians and to assess their overall survival depending on baseline characteristics, type of treatment modality, and possible procedure-related complications. A retrospective clinical study was carried out.
METHODS: A total of 383 patients aged >80 years, referred with suspected peripheral arterial disease, were categorized into octogenarians and nonagenarians. Data regarding cardiovascular risk factors, comorbidities, type of treatment, and possible procedure-related complications were collected from patients' files. The cohort was followed up for total mortality until December 31, 2007, by means of record linkage with the National Causes of Death Register.
RESULTS: A total of 57 (14.9%) patients were treated surgically, whereas 71 (18.5%) underwent an endovascular procedure. Conservative treatment was chosen significantly more often for nonagenarians (p = 0.032). Postoperative complications (nonfatal, 13.2%; fatal, 3.1%) were equally distributed between the age groups and genders (p = 0.840 and p = 0.820, respectively) but were significantly more common after surgical procedures (p < 0.001 for both fatal and nonfatal complications). As expected, the overall survival was significantly poorer among nonagenarians as compared with octogenarians (33 vs. 45 months, respectively; p < 0.001). Older age, critical limb ischemia (CLI), and males were independently associated with mortality (odds ratio [OR]: 1.89, 95% confidence levels [CI]: 1.18-3.04; OR: 3.72, 95% CI: 2.34-5.91; and OR: 1.77, 95% CI: 1.10-2.80, respectively). The survival for nonagenarian men with CLI was 24 months and for women 28, regardless of the treatment modality.
CONCLUSIONS: Octo- and nonagenarians seem to tolerate arterial reconstruction relatively well. Endovascular interventions should be favored over surgical procedures as they are associated with fewer complications. At the same time, the life expectancy of nonagenarians with CLI is limited to approximately 2 years, irrespective of the method of treatment. Further studies should be conducted to clarify the actual effect of vascular reconstructions among the elderly population with regard to benefits of both costs and quality of life.
Authors:
Ville K Koskela; Juha Salenius; Velipekka Suominen
Publication Detail:
Type:  Journal Article     Date:  2010-10-06
Journal Detail:
Title:  Annals of vascular surgery     Volume:  25     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  169-76     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Tampere University, Faculty of Medicine Tampere, Finland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Midterm results of endovascular repair of thoracic aortic false aneurysm formation after coarctation...
Next Document:  Surgical repair of a giant pseudoaneurysm of the right common carotid artery following a gunshot.