Autonomy Following Revascularisation in 80-year-old Patients with Critical Limb Ischaemia

• Published in: European journal of vascular and endovascular surgery Vol. 44; no. 6; pp. 562 - 567
• Main Authors: Lejay, A, Thaveau, F, Georg, Y, Bajcz, C, Kretz, J.-G, Chakfé, N
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2012
• Subjects: Activities of Daily Living; Age Factors; Aged, 80 and over; Amputation; Autonomy; Chi-Square Distribution; Critical Illness; Critical limb ischaemia; Endarterectomy - adverse effects; Endarterectomy - mortality; Endovascular Procedures - adverse effects; Endovascular Procedures - mortality; Endovascular surgery; Humans; Ischemia - mortality; Ischemia - physiopathology; Ischemia - surgery; Kaplan-Meier Estimate; Limb Salvage; Lower Extremity - blood supply; Octogenarians; Open surgery; Patient Selection; Personal Autonomy; Postoperative Complications - etiology; Postoperative Complications - surgery; Recovery of Function; Reoperation; Retrospective Studies; Risk Assessment; Risk Factors; Surgery; Time Factors; Treatment Outcome; Vascular Grafting - adverse effects; Vascular Grafting - mortality; Vascular Patency; Critical limb ischaemia; Endovascular surgery; Octogenarians; Autonomy; Open surgery
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2012.09.007

Abstract Objectives We wanted to compare autonomy recovery after open and endovascular infrainguinal surgery for critical limb ischaemia (CLI) in octogenarians. Materials and methods We performed a retrospective analysis of 167 consecutive CLI octogenarians who underwent infrainguinal open surgery (OS) or endovascular surgery (ES) between 2003 and 2008. OS and ES groups were compared in terms of autonomy level (Parker score), survival, limb salvage and patency rates. Results Preoperative autonomy level was similar in both groups (OS n  = 109, ES n  = 58) but 6-month postoperative autonomy level was better after ES ( p  = 0.01). There was a trend towards better survival after OS (74% at 1 year, 62% at 2 years, 32% at 4 years with OS and 68%, 50%, 17% respectively for ES p  = 0.06), but no difference regarding limb salvage (91% at 1 year, 90% at 2 years, 89% at 4 years for OS and 94%, 87%, 86% respectively for ES, p  = 0.939) and primary patency (76% at 1 year, 59% at 2 years, 50% at 4 years for OS and 82%, 75%, 32% respectively for ES, p  = 0.467). Conclusions ES is justified in CLI octogenarians, because it allows restoring a higher autonomy level, with limb salvage and patency rates comparable to OS.