Cirugía infragenicular en pacientes ancianos: el valor de la edad

Summary Aims . The aim of this study was to compare medium term (36 months) results of below-the-knee revascularisation procedures performed for limb salvage between two cohorts of patients: those under the age of 75 and patients over 75 years old. Patients and methods. Over a period of 24 months a total of 108 below-the-knee bypasses were carried out consecutively on 98 patients, 55 of whom were under the age of 75 (group A) and 43 over 75 years old (group B). Arteriography showed that 60% of the cases in group A had an efferent vessel (55.8% in group B). Distal anastomosis was performed in the 3rd portion in 31% in group A (32% in group B), and the others involved distal vessels, with saphenous vein graft in 65.5% of the patients in group A and 55.3% in group B. Results. Deaths occurred in one case in group A and two in group B. Survival at 36 months was 85.2% in group A versus 76.6% in group B; primary patency was 57.2% for group A compared to 58.1% in group B; and salvage rate was 70% in group A and 69.9% in group B. The log rank test revealed no statistically significant differences for any of the parameters. Conclusions. Revascularisation is acceptable and to be recommended in elderly patients selected for limb salvage surgery. [ANGIOLOGIA 2004; 56: 539-47]