Late results of peripheral vascular surgery in patients 80 years of age and older.

During a seven-year period, 114 patients 80 years of age and older underwent 119 peripheral arterial procedures. There were 26 elective aortic reconstructions, nine ruptured abdominal aortic aneurysm (AAA) repairs, 33 femoropopliteal bypasses, 13 femorotibial bypasses, 21 femoral embolectomies, and 17 miscellaneous procedures. Early mortality, morbidity, and Goldman cardiac risk factors were determined by chart review. All 48 survivors returned for current noninvasive vascular examination and life-style assessment. Perioperative mortality after elective AAA resection was 4.3%, vs 78% after ruptured AAA. Perioperative mortality after infrainguinal bypass was nil. Five-year survivals after elective aortic and infrainguinal reconstructions were 54% and 30%, respectively. Of 18 patients studied 19 to 68 months after infrainguinal bypass, limb salvage was achieved in 83% and graft patency in 76%. Thirty-one long-term survivors (65%) were living at home. Only seven patients (15%) were confined to a wheelchair or were bedridden, and 28 (58%) were fully ambulatory. Peripheral arterial reconstruction in patients 80 years of age and older can be performed safely with excellent long-term survival and quality of life.