Minimally Invasive Approaches to Vascular Procedures in the Elderly

The diagnosis of IC carries only a slight risk for progression to limb-threatening ischemia and may be managed conservatively with good outcomes. Active elderly patients who have lifestyle-limiting claudication, however, may benefit from percutaneous intervention. Candidates should be carefully screened to ensure the absence of secondary morbidity (eg, severe chronic obstructive pulmonary disease caused by cigarette smoking) that would continue to prevent ambulation despite successful intervention. CLI denotes a poor overall prognosis for the elderly patient, largely because of the excessive cardiovascular and cerebrovascular mortality that accompanies this diagnosis. Bedridden patients and those who have joint contractures are usually best served by primary amputation. Candidates for revascularization may be offered an angioplasty-first treatment plan, although a substantial fraction of these patients require repeat angiographic intervention or surgical bypass at a later date.