709-5 Peripheral Angioplasty in the Elderly: Safe and Beneficial

Abstract

The outcome of percutaneous transluminal angioplasty (PTA) of lower extremity peripheral arterial disease (PAD) in the elderly is not well documented. Between June 1988 and June 1994, 206 patients (pts) had PTA for symptomatic PAD. Cohorts of patients greater than 70 years (78 pts, 105 PTA's, mean age 76 years), and less than 70 years (128 pts, 188 PTA's, mean age 60 years, P < 0.0001) were analyzed. The younger patients were more frequently males (75% vs 52%, P < 0.0001), smokers (45% vs 23%, P < 0.0001), with higher prevalence of coronary disease (76% vs 60%, P < 0.006), and hyperlipidemia (70% vs 51%, P < 0.02). The prevalence of diabetes and hypertension was similar. Patients above 70 years of age (398 lesions), and patients less than 70 years of age (509 lesions) had different lesion distribution. Older patients tended to have more diffuse and distal disease (P < 0.0001). However, the success rate of PTA was similar in both groups (96 vs 97% for all lesions, P = NS), and 84 vs 89% for total chronic occlusions (P = NS) in younger versus older patients. Complication rates did not differ significantly between groups. There were no strokes, infarctions, amputations, emergent bypasses, or deaths in either group. A mean follow-up of 29 ± 20 months, the symptomatic improvement was 77% versus 62% in younger versus older patients ( < 0.55 NS). There was no significant difference in the rate of revascularization by PTA or bypass surgery in both groups. 1) Elderly patients with PAD have more underlying risk factors and more extensive and distal disease than younger patients. In spite of this, procedural success and complication rates are similar for the two age groups. 2) Symptomatic improvement after PTA can be maintained for extended periods of time in the elderly patients.