SURGICAL PATHOLOGY OF AORTA AND ARTERIES OF THE LOWER-LIMBS IN THE ELDERLY

From 1.1.1988 tot 31.8.1991, 42 surgical revascularisations of the aor ta and the lower limbs were performed on patients aged 75 and more (me n : 24 - women : 18 ; extreme ages : 75-84 ; average age : 80). In all cases surgery was absolutely indicated: for advanced arteriopathy in the lower limbs (stage III or IV of Fontaine's classification) (37 cas es) and ruptured abdominal aortic aneurysm (5 cases). No primary major amputation was performed in the peripheral vascular group stages III and IV. Peripheral vascular occlusive disease (30 cases) was operated under locoregional anaesthesia and consisted of the femoro-distal popl iteal bypass with in situ saphenous vein (23 cases). Patients with pro ximal lesions preferably underwent an extra-anatomic bypass under gene ral anaesthesia (7 cases). Ruptured infrarenal aortic aneurysm also ne eds a general anesthesia and represents a high surgical risk (5 cases) . For the 42 patients, we observed 38 good immediate functional result s and 4 peri-operative deaths. Of the 38 immediate good results, we ob served 6 secondary obliterations of the bypass within a period of 5 to 18 months, among which 2 were successfully desobliterated. The other 4 patients underwent lower limb amputation.