Vascular Reconstruction in the Octogenarian

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Abstract
The octogenarian has usually been considered too old to have resection of a 6 cm abdominal aortic aneurysm, which is as life-threatening as a carcinoma of the colon. Other vascular lesions can also be a threat to the mobility of the elderly person. Our approach to debilitating lesions such as these has been to offer reconstructive surgery if the patient's general condition warrants. Improvements in monitoring and patient care have allowed us to perform 174 primary vascular procedures in 144 patients with a hospital mortality of 5.5%. We believe the complication rate (13.8%) also to be acceptable. Cerebrovascular reconstruction was performed 52 times in 45 patients. Significant complications occurred twice and two patients died. Twenty-one aortic aneurysms were resected; five were ruptured. Death occurred in three patients. Lower extremity revascularization was performed 85 times in 65 patients. Embolectomy was done in 14 patients and upper extremity revascularization in two. Three patients in these last groups died. These results lead us to believe that, in a hospital with excellent support systems, an operative approach to debilitating vascular problems is justified.

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