Surgical results of acute thromboembolic limb ischemia in octogenarians

Abstract

Objectives: The aim of this study was to evaluate surgical outcomes of octogenarian patients presenting with acute limb ischemia (ALI) andundergoing urgent thromboembolectomy.Patients and methods: Between January 2016 and March 2018, the medical charts of a total of 27 octogenarian patients (16 females, 11 males;median age 85.2±4.3 years; range, 80 to 95 years) who were diagnosed with acute thromboembolic ischemia of the lower or upper limb and underwenturgent thromboembolectomy at our institution were retrospectively analyzed. The 30-day mortality rate of ALI was evaluated. Demographic andclinical characteristics of the patients, associated pathologies, and postoperative outcomes including infection, gastrointestinal bleeding, hematoma,revision surgery, and amputation were recorded.Results: Nineteen patients (70.3%) had acute lower limb ischemia, while eight patients (29.7%) had acute upper limb ischemia. Acute ischemicpain was the most commonly seen symptom (n=26, 96.3%). Atrial fibrillation was the most common comorbidity in 62.9% patients. Postoperativecomplications included hematoma (n=5, 18.5%), wound infection (n=4, 14.8%), and gastrointestinal bleeding (n=2, 7.4%). Re-embolectomy wasperformed in three patients (11.1%). Fasciotomies were performed during follow-up due to compartment syndrome in three patients (11.1%) andthese patients subsequently underwent lower limb amputation. The 30-day mortality occurred in two patients due to renal failure and the mortalityrate was found to be 7.4%.Conclusion: Based on our study results, ALI in octogenarians has different outcomes. Our findings suggest that patients with neurological deficit due to delayed ischemia and those with diabetes mellitus and severe ischemia face a higher risk in mortality and morbidity