Clinical Outcomes after Revascularization for Chronic Limb-threatening Ischemia: A comparative Study of Elderly and Non-elderly Patients

Abstract

 Introduction: The number of elderly patients with chronic limb-threatening ischemia (CLTI) is increasing; however, studies on the prognosis of revascularization in this population remain limited. This study compared postoperative outcomes between elderly and non-elderly CLTI patients undergoing revascularization at our institution.

 Materials and Methods: A total of 135 cases who underwent revascularization for CLTI with tissue loss at our institution between January 2015 and December 2023 were included. Outcomes were compared between elderly (n=50) and non-elderly patients (n=85). The primary outcomes were limb salvage and overall survival. Multivariate analysis using Cox proportional hazards regression model was performed to adjust for potential confounding patient characteristics, and outcomes were compared between groups after adjustment for significant confounders.

 Results: The elderly group exhibited lower rates of diabetes and dialysis and a higher proportion of females. After adjusting for confounders, overall survival was significantly worse in the elderly group than in the non-elderly group, whereas no significant difference was observed in limb salvage between the two groups.

 Conclusion: Revascularization should be considered for patients with CLTI regardless of age. However, elderly patients may have poorer overall survival; thus, careful assessment of life expectancy and procedural risk is important when selecting treatment strategies in this population.