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Risks and Benefits of Peripheral Arterial Reconstructions in Octogenerians

The purpose of this study is to analyze the real benefit of peripheral arterial reconstructions of very old patients in relation to the underlying risk in terms of hospital mortality, long-term survival, amputation rate and level, grade of reha bilitation, and relief of symptoms. In this retrospective analysis, 120 patients with an average age of 85 years were evaluated, 224 peripheral arterial recon structions, repeat-operations, and amputations having been performed. Limb salvage was the leading indication for surgery in 93% of all patients, disabling claudication in only 7%. Twenty-one patients (18%) died in the hospital, 65 (54%) survived the opera tion for an average of 2½ years, and 34 (28%) are still alive at the end of the observation period; 34 (28%) required amputations and 65 (54%) improved; 81 patients (69%) were ambulant on discharge from the hospital, 68 (79%) in the group without amputation but only 13 (38%) in the amputated group. This study comes to the conclusions that more than half of the octogenerians benefited from peripheral arterial reconstructions, that the risk of arterial re constructions is acceptable even in this poor-risk group of patients, and finally that arterial reconstructions should be tried whenever feasible to improve the old patient's chance for rehabilitation.