Results of vascular surgery in younger versus older patients

N-Hsiang, York; Hildebrand, Henry D.

doi:10.1016/0002-9610(89)90590-4

Cited by 10 publications

(7 citation statements)

References 12 publications

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“…Two studies (174 patients) were identified for DTAF. 4,5 Six studies included data for both AFB and IFB and one study included data for AFB, IFB and AIE 19,29,34,41,49,52 (Tables 1e7).…”

Section: Resultsmentioning

confidence: 99%

Review of Direct Anatomical Open Surgical Management of Atherosclerotic Aorto-Iliac Occlusive Disease

Chiu

Davies

Nightingale

et al. 2010

European Journal of Vascular and Endovascular Surgery

155

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“…Two studies (174 patients) were identified for DTAF. 4,5 Six studies included data for both AFB and IFB and one study included data for AFB, IFB and AIE 19,29,34,41,49,52 (Tables 1e7).…”

Section: Resultsmentioning

confidence: 99%

Review of Direct Anatomical Open Surgical Management of Atherosclerotic Aorto-Iliac Occlusive Disease

Chiu

Davies

Nightingale

et al. 2010

European Journal of Vascular and Endovascular Surgery

155

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“…Our amputation rate of 23.5% correlates with other studies that reported amputation rates ranging from 20.7% to 31% in patients younger than 50 years. 1,4,9 One study found this to be a threefold increase when comparing patients younger and older than 50 years. 4 In addition, ipsilateral repeat operations were frequently required in these young patients.…”

Section: Discussionmentioning

confidence: 99%

“…1 This form of atherosclerosis, unlike that in elderly patients, is considered an aggressive disease with rapid progression and poor prognosis. 1,[4][5][6][7][8][9][10] The cause of premature atherosclerosis is unclear. Several factors have been identified that may increase risk for accelerated atherosclerosis in young patients.…”

mentioning

confidence: 99%

“…11 Controversy has surrounded lower extremity revascularization in young patients. 1,4,8,12 Increased perioperative complications and poor outcome has been reported in young patients undergoing vascular surgery. 1,9,10,13,14 Levy et al 1 demonstrated that in patients younger than 40 years requiring lower-extremity bypass grafting the rate of secondary procedures was 53% and the amputation rate was 27%.…”

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confidence: 99%

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Outcome of lower-extremity revascularization in patients younger than 40 years in a predominately diabetic population

Saltzberg

Pomposelli

Belfield

et al. 2003

Journal of Vascular Surgery

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“…4,5 However, it is important to realize that many of these guidelines were derived from trials that included almost exclusively elderly patients. A few studies on revascularization procedures in young patients have shown inferior outcomes compared to elderly PAD patients, [6][7][8][9][10][11] although other studies have shown conflicting data. [12][13][14][15][16][17] Differences in the detection and management of PAD in females have been more widely studied.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of open and endovascular infra-inguinal revascularization are poor in young patients with atherosclerotic peripheral artery disease but do not differ between genders

et al. 2022

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Objectives The effect of gender on the outcomes of revascularization procedures in young patients with premature atherosclerotic peripheral arterial disease (PAD) is not known. The objective of this study was to compare short-term and long-term outcomes between young males and females undergoing infra-inguinal revascularization procedures. Methods We examined postoperative outcomes of male and female PAD patients under the age of 55 who underwent infra-inguinal revascularization procedures at a single tertiary institution from 2011 to 2019. Primary outcomes included 30-day morbidity, patency of the revascularization procedures, and major adverse limb events (MALE). Secondary outcomes included survival, amputation rate, reintervention rate, improvement of ankle-brachial index (ABI), and number of reinterventions. Results Eighty-one infra-inguinal revascularization procedures (46 endovascular and 35 open procedures) were reviewed including 45 procedures in 37 males and 36 procedures in 31 females. Fifty-three (65.4%) of the procedures were performed in patients with chronic limb-threatening ischemia symptoms. The rest were treated for life-disabling claudication. The female patients were younger, had higher body mass index, and were more likely to have diabetes, hyperlipidemia, or chronic obstructive pulmonary disease in comparison to males. Thirty-day major adverse cardiovascular event was 0.0% and MALE was 16.0%. Mean follow-up was 806.2 days. At 1 year, primary patency was 34.4 ± 6.2%, primary assisted patency was 52.7 ± 6.5%, secondary patency was 61.8 ± 6.3%, and MALE-free rate was 47.0 ± 6.4%. For secondary outcomes at 1 year, amputation-free rate was 92.5 ± 3.2%, reintervention-free rate was 50.2 ± 6.4%, and survival was 96.2 ± 2.6%. By the end of the study, overall mortality rate was 14.8% and major amputation rate was 13.6%. No major differences were observed between males and females among these outcomes. A smaller improvement in ABI after revascularization was noted in females compared to males (female 0.2 ± 0.2 vs male 0.4 ± 0.2, p = .04). Among patients who required reintervention, females required a higher number of reinterventions than males (female 1.7 ± 2.5 vs male 0.8 ± 1.1, p = .03). Conclusions There were no significant differences in short-term and long-term outcomes between males and females under the age of 55 after infra-inguinal revascularization. Poor patency, high MALE rate, and high mid-term mortality, and amputation rates after revascularization in young PAD patients highlight the need for improved strategies to treat premature PAD.

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Results of vascular surgery in younger versus older patients

Cited by 10 publications

References 12 publications

Review of Direct Anatomical Open Surgical Management of Atherosclerotic Aorto-Iliac Occlusive Disease

Review of Direct Anatomical Open Surgical Management of Atherosclerotic Aorto-Iliac Occlusive Disease

Outcome of lower-extremity revascularization in patients younger than 40 years in a predominately diabetic population

Outcomes of open and endovascular infra-inguinal revascularization are poor in young patients with atherosclerotic peripheral artery disease but do not differ between genders

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