Our Summary

This research studied if there were any differences in the outcomes of a common leg blood vessel surgery (femoral-popliteal bypass or FPB) in patients over and under 80 years old. The data used for this study came from an existing hospital registry between 2009 and 2013.

The study found 24 patients over 80 and 72 patients under 80 who had undergone the surgery. The older patients had lower rates of smoking and higher rates of high blood pressure. However, other medical factors were similar between the two groups.

Both groups showed no differences in the type of vein used for the surgery or where the surgery was performed on the leg. The reason for having the surgery varied significantly between the two groups. The older group mainly underwent the surgery to save the limb or due to pain at rest, while the younger group mainly had the surgery to relieve pain during walking.

There were no differences in the rates of rehospitalizations within 30 days or complications during or after surgery between the two groups. However, the older patients did stay in the hospital for about 5 days longer on average.

The effectiveness of the surgery seemed to drop faster in the older patients after six months, but there were no significant differences overall. Where the surgery was performed on the leg, the type of vein used, and the reason for the surgery did not predict how long the surgery would be effective.

In conclusion, the study suggests that this surgery is as safe and effective in patients over 80 as in younger patients, although the older patients did stay longer in the hospital. The researchers call for more studies with larger groups of patients to confirm these results.

FAQs

  1. What were the primary reasons for older patients to undergo femoral-popliteal bypass surgery?
  2. Was there any difference in the rates of rehospitalization or complications during or after surgery between the older and younger patients?
  3. Did the effectiveness of the femoral-popliteal bypass surgery decrease more rapidly in patients over 80 compared to those under 80?

Doctor’s Tip

A helpful tip a doctor might tell a patient about femoral-popliteal bypass is to closely follow post-operative care instructions, including proper wound care, medication management, and physical therapy. It is also important to attend follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider promptly. Additionally, maintaining a healthy lifestyle, including quitting smoking and managing high blood pressure, can help improve the long-term success of the surgery.

Suitable For

Patients who are typically recommended for femoral-popliteal bypass surgery are those who have peripheral arterial disease (PAD) that affects the femoral and popliteal arteries in the leg. This surgery is often recommended for patients who have severe blockages in these arteries, which can lead to symptoms such as leg pain, numbness, or difficulty walking. In some cases, the surgery may be recommended to prevent limb amputation in patients with critical limb ischemia.

This study specifically looked at patients over 80 years old who underwent femoral-popliteal bypass surgery, but in general, patients of all ages may be recommended for this procedure depending on their individual health and medical history. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if femoral-popliteal bypass surgery is the best course of action for their specific condition.

Timeline

Overall, the timeline of a patient’s experience before and after femoral-popliteal bypass surgery may include:

  • Initial diagnosis of peripheral artery disease and consultation with a vascular surgeon
  • Pre-operative evaluations, including imaging tests and blood work
  • Surgery scheduling and preparation, including discussion of the procedure and potential risks
  • The surgery itself, which involves creating a new pathway for blood flow in the leg
  • Post-operative recovery in the hospital, which may include pain management and physical therapy
  • Follow-up appointments to monitor the success of the surgery and address any complications
  • Long-term management of peripheral artery disease, which may include lifestyle changes and medications

Overall, femoral-popliteal bypass surgery can be a safe and effective treatment option for patients with peripheral artery disease, regardless of age.

What to Ask Your Doctor

Some questions a patient should ask their doctor about femoral-popliteal bypass include:

  1. What are the potential risks and complications associated with the surgery?
  2. How long will I need to stay in the hospital after the surgery?
  3. What is the expected recovery time and rehabilitation process?
  4. Will I need to make any lifestyle changes after the surgery?
  5. How long can I expect the surgery to be effective in improving blood flow to my leg?
  6. What are the alternatives to femoral-popliteal bypass and why is this procedure recommended for me?
  7. How frequently will I need follow-up appointments after the surgery?
  8. Are there any specific factors about my age or medical history that may impact the success of the surgery?
  9. What can I do to help ensure a successful outcome of the surgery?
  10. Are there any specific signs or symptoms I should watch out for after the surgery that may indicate a complication?

Reference

Authors: Hu J, Safir S, Bangiyev R, Weber J, Faries P, Vouyouka A, Lajos P. Journal: Surg Technol Int. 2024 Jul 15;44:223-229. doi: 10.52198/24.STI.44.CV1793. PMID: 38900593