Dr. Kevin M. Casey, a board-certified surgeon at Santa Barbara Vascular Specialists, has co-authored a study that is making significant strides in the field of vascular surgery.
The study focuses on peripheral arterial disease (PAD) in nonagenarians (those 90-99 years old), and has been published in the academic journal “Elsevier.”
PAD is a condition where patients suffer from decreased lower extremity arterial perfusion, often referred to as “poor circulation.”
The study, titled “Frailty is Not Associated with Worse Outcomes Following Lower Extremity Angiograms for Limb Ischemia in Nonagenarians,” aims to shed light on the safety and efficacy of endovascular interventions in this older population.
One key aspect of the study is that it disproves the notion that frailty, as measured by the modified frailty index (MFI-11), was associated with worse outcomes in this patient population.
The research shows that frail patients do not have significantly different 30-day or 12-month outcomes compared to non-frail patients. Consequently, there exists an alternative, safe course of action prior to considering amputation.
The research conducted by Dr. Casey and his co-authors spanned a 12-year period and included 76 patients with an average age of 93.
The study focused on patients who underwent endovascular procedures for both acute limb ischemia (ALI) and chronic limb-threatening ischemia (CLTI). The primary outcomes measured included 30-day and 12-month limb salvage and mortality rates.
The findings from the study are in some ways counter to traditional medical thinking. The 30-day amputation and mortality rates were only 6% and 8%, respectively, which demonstrates that endovascular procedures can be performed safely in nonagenarians with low mortality and amputation rates.
Patients who underwent early amputation within 30 days had significantly higher mortality rates at 12 months compared to those who did not undergo amputation.
The findings have far-reaching implications for the elderly population, especially in areas where the elderly population has a more robust functional status than the national average.
The study suggests that minimally invasive endovascular procedures should be considered as a beneficial option for nonagenarian patients with limb ischemia, providing hope and improved quality of life for these individuals and their families.
This research was presented at the 2022 Western Vascular Society Annual Meeting, in Victoria, British Columbia.