Long-term outcomes of endovascular treatment of critical limb ischemia in very elderly Chinese patients: A single Hong Kong center experience
Refereed conference paper presented and published in conference proceedings


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AbstractINTRODUCTION: Primary amputation has been the predominant treatment for critical limb ischemia (CLI) in Hong Kong until the introduction of endovascular therapy (EVT) in recent years. There is a paucity of data involving Chinese elderly patients with CLI.
OBJECTIVE: To determine long-term outcomes of EVT for CLI in elderly patients aged 75 years and over.
METHODS: Retrospective analysis of consecutive patients ≥75 years who underwent attempted EVT for CLI between 1st January 2009 and December 2015 at a single tertiary referral hospital in Hong Kong. Minimum follow-up was 6 months with a maximum of 109 months. Primary endpoint was amputation-free survival (AFS) at 12-months. Secondary endpoints included 12-month freedom from major adverse limb events (MALE, consisting of major amputation and major vascular re-intervention) in the index limb.
RESULTS: EVT were attempted in 151 critically ischemic limbs of 128 patients (35.9% men, mean age 82.8 ± 4.8 years). Of these, 122 patients (95.3%) had significant co-morbidities such as coronary artery disease (24.2%), stroke (23.4%), chronic renal failure/dialysis (10.2%), diabetes (57.0%) and hypertension (91.4%). Indication for revascularization was Rutherford class 4 (n=31, 20.5%), 5 (n=106, 70.2%) and 6 (n=14, 9.3%). The anatomical segments involved were iliac (16.2%), superficial femoral (68.9%), popliteal (27.0%) and infra-popliteal (57.4%). Technical success rate was 93.2% procedures. Early complications occurred in 12.6% of procedures. The 30-day mortality rate was 7.8%. Median (range) in-hospital stay was 7 (1 to 84) days. There were 20 major limb amputations (13.2%) during the study period. Six-, 12-, 24,- and 36-month amputation-free-survival rate was 71.9%, 66.4%, 55.5% and 50.8% and MALE-free-survival rate was 86.1%, 83.4%, 80.8% and 80.8%, respectively.
CONLCUSIONS: Endovascular therapy is safe and is effective in preventing major amputations in very elderly patients with CLI. However, mortality rates remained high which may reflect underlying co-morbidities of this group of patients.
All Author(s) ListBryan Yan, Gormin Tam, Christy Chan, Lily Li, Olivia To, James Lau
Name of Conference2016 AMP - Amputation Prevention Symposium
Start Date of Conference10/08/2016
End Date of Conference13/08/2016
Place of ConferenceChicago
Country/Region of ConferenceUnited States of America
Year2016
LanguagesEnglish-United States

Last updated on 2018-25-07 at 15:49