Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases

Hsuan-Li Huang,1 Jyh-Ming Jimmy Juang,2 Hsin-Hua Chou,1,3 Chien-An Hsieh,1 Shih-Jung Jang,1 Shih-Tsung Cheng,1,3 Yu-Lin Ko1,3 1Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, 2Cardiovascular Center and Division...

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Autores principales:	Huang HL, Jimmy Juang JM, Chou HH, Hsieh CA, Jang SJ, Cheng ST, Ko YL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	peripheral artery disease octogenarian endovascular therapy cardiovascular outcomes Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/a84678ca899e4879a5f20c4b7fb3fb0c
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spelling	oai:doaj.org-article:a84678ca899e4879a5f20c4b7fb3fb0c2021-12-02T06:51:17ZImmediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases1178-1998https://doaj.org/article/a84678ca899e4879a5f20c4b7fb3fb0c2016-05-01T00:00:00Zhttps://www.dovepress.com/immediate-results-and-long-term-cardiovascular-outcomes-of-endovascula-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Hsuan-Li Huang,1 Jyh-Ming Jimmy Juang,2 Hsin-Hua Chou,1,3 Chien-An Hsieh,1 Shih-Jung Jang,1 Shih-Tsung Cheng,1,3 Yu-Lin Ko1,3 1Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, 2Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, 3School of Medicine, Tzu Chi University, Hualien, Taiwan Purpose: To investigate the clinical outcomes of endovascular therapy (EVT) in octogenarians and nonoctogenarians with peripheral arterial disease. Methods: A retrospective analysis of 511 patients (654 affected legs) who underwent EVT between July 2005 and December 2013 was conducted in a prospectively maintained database. Immediate results and long-term vascular outcomes were analyzed and compared between octogenarians and nonoctogenarians. Results: Octogenarians were more likely to be female and have atrial fibrillation (AF), whereas nonoctogenarians had higher rates of obesity, claudication, and medical comorbidities. There were no differences in the rates of EVT success, 30-day major adverse vascular events, and 6-month functional improvement between groups. Over the 10-year follow-up period, the rates of 3-year limb salvage, sustained clinical success, freedom from major cerebrovascular and cardiovascular events, and composite vascular events were similar between groups, but the survival rate was better in nonoctogenarians than in octogenarians (73% vs 63%, respectively, P=0.004). In Cox regression analysis, dependence on dialysis and AF were significant predictors of death (odds ratio [OR] 4.44 in dialyzed and 2.83 in AF patients), major cerebrovascular and cardiovascular events (OR 3.49 and 2.45), and composite vascular events (OR 3.14 and 2.25). Conclusion: EVT in octogenarians was feasible, without an increased risk of periprocedural complications. The rates of limb salvage, sustained clinical success, and long-term vascular events were comparable between groups. Dialysis dependence and AF are independent predictors for poor prognosis in patients with peripheral arterial disease. However, these observations require further confirmation in larger scale studies. Keywords: peripheral artery disease, octogenarians, endovascular therapy, cardiovascular outcomes, dialysis, atrial fibrillationHuang HLJimmy Juang JMChou HHHsieh CAJang SJCheng STKo YLDove Medical Pressarticleperipheral artery diseaseoctogenarianendovascular therapycardiovascular outcomesGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 535-543 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	peripheral artery disease octogenarian endovascular therapy cardiovascular outcomes Geriatrics RC952-954.6
spellingShingle	peripheral artery disease octogenarian endovascular therapy cardiovascular outcomes Geriatrics RC952-954.6 Huang HL Jimmy Juang JM Chou HH Hsieh CA Jang SJ Cheng ST Ko YL Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases
description	Hsuan-Li Huang,1 Jyh-Ming Jimmy Juang,2 Hsin-Hua Chou,1,3 Chien-An Hsieh,1 Shih-Jung Jang,1 Shih-Tsung Cheng,1,3 Yu-Lin Ko1,3 1Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, 2Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, 3School of Medicine, Tzu Chi University, Hualien, Taiwan Purpose: To investigate the clinical outcomes of endovascular therapy (EVT) in octogenarians and nonoctogenarians with peripheral arterial disease. Methods: A retrospective analysis of 511 patients (654 affected legs) who underwent EVT between July 2005 and December 2013 was conducted in a prospectively maintained database. Immediate results and long-term vascular outcomes were analyzed and compared between octogenarians and nonoctogenarians. Results: Octogenarians were more likely to be female and have atrial fibrillation (AF), whereas nonoctogenarians had higher rates of obesity, claudication, and medical comorbidities. There were no differences in the rates of EVT success, 30-day major adverse vascular events, and 6-month functional improvement between groups. Over the 10-year follow-up period, the rates of 3-year limb salvage, sustained clinical success, freedom from major cerebrovascular and cardiovascular events, and composite vascular events were similar between groups, but the survival rate was better in nonoctogenarians than in octogenarians (73% vs 63%, respectively, P=0.004). In Cox regression analysis, dependence on dialysis and AF were significant predictors of death (odds ratio [OR] 4.44 in dialyzed and 2.83 in AF patients), major cerebrovascular and cardiovascular events (OR 3.49 and 2.45), and composite vascular events (OR 3.14 and 2.25). Conclusion: EVT in octogenarians was feasible, without an increased risk of periprocedural complications. The rates of limb salvage, sustained clinical success, and long-term vascular events were comparable between groups. Dialysis dependence and AF are independent predictors for poor prognosis in patients with peripheral arterial disease. However, these observations require further confirmation in larger scale studies. Keywords: peripheral artery disease, octogenarians, endovascular therapy, cardiovascular outcomes, dialysis, atrial fibrillation
format	article
author	Huang HL Jimmy Juang JM Chou HH Hsieh CA Jang SJ Cheng ST Ko YL
author_facet	Huang HL Jimmy Juang JM Chou HH Hsieh CA Jang SJ Cheng ST Ko YL
author_sort	Huang HL
title	Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases
title_short	Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases
title_full	Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases
title_fullStr	Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases
title_full_unstemmed	Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases
title_sort	immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/a84678ca899e4879a5f20c4b7fb3fb0c
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Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases

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