Eur J Vasc Endovasc Surg 2003;26:65-8.

Infrapopliteal bypass reduces amputation incidence in elderly patients: a population-based study.

Eskelinen E, Luther M, Eskelinen A, Lepäntalo M.

OBJECTIVE: To examine the association between the incidences of infrapopliteal bypass for critical limb ischaemia (CLI) and major amputation in Finns aged >or=70 years.

METHODS: Patients undergoing infrapopliteal bypass or major amputation for CLI during 1997 were retrospectively analysed. The incidence of major amputation in a group of hospitals performing infrapopliteal bypass “actively” was compared to that in a group performing such surgery “passively”.

RESULTS: The incidence of major amputations in the active (978 bypasses per million inhabitants) and passive (57 per million) groups was 1976 and 3177 per million, respectively (p = 0.016). There was a significant (p = 0.012) inverse relationship between the incidence of the two procedures in patients aged >or=80, but not <80 years.

CONCLUSIONS: These results suggest that infrapopliteal bypass is effective in reducing the requirement for major amputation in patients aged >or=80 years.

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