Revascularization in octogenarians

In people above 80 years, we are generally hesitant to advice surgical revascularizations even though there are reports suggesting good results are possible in some of them. Critical limb ischaemia (CLI) defines a very advanced stage of chronic arterial insufficiency associated with high risk of major amputation and high risk of reduced quality of life. The estimated prevalence of CLI is 0.24%, and increases with patients’ ages. With ageing population, vascular physicians have to treat an increasing number of octogenarians suffering from CLI. For these patients, the main objective of revascularisation procedure is limb salvage and also improve the quality of life so that they become independent to attend to all their daily activities.In one of the recent studies 167 octogenarians under going open and endovascular surgery were examined for the degree of autonomy after the interventions. It was concluded that endovascular surgery is justified in octogenarians, as this is restoring higher autonomy with limb salvage and patency rates comparable to open surgery. 

Reference:
EJVES 2012 Dec; 44(6):562-567