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Complications of infrainguinal revascularization procedures in elderly patients


Authors: P. Šeliga;  J. Vaško;  P. Kováč;  M. Šimko 1
Authors‘ workplace: Oddelenie cievnej chirurgie FNsP J. A. Reimana, Prešov, Slovenská republika ;  Oddelenie rádiodiagnostiky FNsP J. A. Reimana, Prešov, Slovenská republika 1
Published in: Kardiol Rev Int Med 2012, 14(1): 31-35

Overview

Complications of infrainguinal revascularization procedures in elderly patients.

Aim:

The authors analyse complications of surgical lower extremity arterial reconstructions in elderly patients. They evaluate experiences and treatment results in patients with this complications.

Methods:
It is a retrospective analysis of the patients hospitalized during years 2003–2008 at the Department of Vascular Surgery of the Teaching Hospital J. A. Reimana with complication after surgical lower extremity arterial reconstruction. During study period they executed 251 lower extremity arterial reconstruction in 209 patients 70 years of age or older. They divide postoperative complications into general, local vascular and local non-vascular.

Results:
From general complications cardiac complications were recorded in 21 patients (8.37%), respiratory complications in 8 patients (3.19%), neurologic complications in 2 patients (0.80%), hematological complications in 21 patients (8.37%) and acute renal insuficiency in 2 patients (0.80%). During study period from local vascular complications 33 cases of reconstruction trombosis occured (13.15%), reconstruction infection occured in 7 cases (2.79%), anastomotic pseudoaneurysm in 1 case (0.40%), hemorrhage in 12 cases (4.78%), failing reconstruction in 6 cases (2.39%) and deep vein trombosis in 1 case (0.40%). From local non-vascular complications of lower extremity arterial reconstructions lymphoceles and lymphatic fistulas occured in 4 cases (1.59%), postoperative extremity edema in 22 cases (8.76%), compartment syndrome in 3 cases (1.20%) and ischemic neuropathy in 2 cases (0.80%).

Conclusion:
Revascularization procedures in elderly patients with acute and chronic lower extremity ischemia are absolutely indicated. Infrainguinal reconstructions have good long term patency rate, limb salvage and functional outcomes. Old age patients aren’t contraindicated for lower revascularization procedures.

Keywords:
infrainguinal revascularization – geriatric age – complications


Sources

1. Nehler MR, Moneta GL, Edwards JM et al. Surgery for chronic lower extremity ischemia in patients eighty or more years of age: Operative results and assessment of postoperative independence. J Vasc Surg 1993; 18: 618–626.

2. Rutherford RB, Baker JD, Ernst C et al. Recomended standards for reports dealing with lower extremity ischemia: Revised version. J Vasc Surg 1997; 26: 517–538.

3. Kyslan K, Mýtnik M, Kyslan K Jr. Zásady úspešnej prevencie ranej infekcie v chirurgii. Slovenská chirurgia 2004; 1: 26–28.

4. Dalman RL. Expected outcome: Early results, life table patency, limb salvage. In: Mills JD (ed.). Management of chronic lower extremity ischemia. London: Arnold 2000: 106–112.

5. Gibson KD, Caps MT, Gillen D et al. Identification of factors predictive of lower extremity vein graft thrombosis. J Vasc Surg 2001; 33: 24–31.

6. Tangelder MJ, Algra A, Lawson, JA et al. Risk factors for occlusion of infrainguinal bypass grafts. Eur J Vasc Endovasc Surg 2000; 20: 118–124.

7. Kyslan K, Barla J, Kyslan K Jr et al. Syndróm AMS a jeho riešenia. Rozhledy v chirurgii 2008; 5: 255–258.

8. Babčák M, Merčiaková M, Németh F. Starnutie z pohľadu diabetológa. Zdravotníctvo a sociálna práca 2006; 1: 42–45.

9. Boroňová I, Bernasovský I, Bernasovská J et al. Detection of Philadelphia chromosome in patients with chronic myeloid leukemia from the Prešov region in Slovakia (1995–2004). Int J Hum Gen 2007; 7: 297–301.

10. Boroňová I, Bernasovský I, Bernasovská J. Detekcia Philadelphia chromozómu u pacientov s chronickou myeloidnou leukémiou v Prešovskom kraji (1995–2004). Klin Onkol 2007; 20: 357–360.

11. Mýtnik M, Daňo J, Straka Ľ. Myxoidný liposarkóm. Slovenská chirurgia 2005; 3: 24–26.

12. Boroňová I, Bernasovský I, Bernasovská J et al. Cytogenetics of chronic myeloproliferative disorders. Slov antropol 2008; 11: 20–27.

13. Boroňová I, Bernasovský I, Bernasovská J et al. Constitutional translocation t(11,22) in Slovak Romanies from the Prešov region (Slovakia). The Anthropologist: International journal of contemporary and applied studies of man 2008; 10: 1–4.

14. Boroňová I, Bernasovský I, Bernasovská J. Chromozómová analýza u pacientov s MDS syndrómom v Prešovskom kraji (1995–2004). Slovenská antropológia: bulletin Slovenskej antropologickej spoločnosti pri SAV 2005; 8: 32–33.

15. Boroňová I, Bernasovský I, Bernasovská J. Detection of fragile X syndrome by cytogenetic methods in the Prešov region in Slovakia (1992–2004). Slovenská antropológia: bulletin Slovenskej antropologickej spoločnosti pri SAV 2005; 8: 42.

16. Ascer E, Collier P, Gupta SK et al. Reoperation for polytetrafluoroethylene bypass failure: The importance of distal outflow site and operative technique in determining outcome. J Vasc Surg 1987; 5: 298–310.

17. Kikta MJ, Goodson SF, Bishara RA et al. Mortality and limb loss with infected infrainguinal bypass grafts. J Vasc Surg 1987; 5: 566–571.

18. Treiman GS, Copland S, Yellin AE et al. Wound infections involving infrainguinal autogenous vein grafts: A current evaluation of factors determining succsesful graft preservation. J Vasc Surg 2001; 33: 948–954.

19. Ariesen MJ, Tangelder MJ, Lawson JA et al. Dutch Bypass Oral Anticoagulants or Aspirin Study Group. Risk of major haemorrhage in patients after infrainguinal venous bypass surgery: Therapeutic consequences? The Dutch BOA (Bypass Oral Anticoagulants or Aspirin) Study. Eur J Vasc Endovasc Surg 2005; 30: 154–159.

20. Babčák M, Racz O a kol. Diabetes mellitus a artériová hypertenzia. Prešov: DAH 2008.

21. Schanzer A, Hevelone N, Owens CD et al. Statins are independently associated with reduced mortality in patients undergoing infrainguinal bypass graft surgery for critical limb ischemia. J Vasc Surg 2008; 47: 774–781.

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