Long-term risk of adverse limb outcomes in older patients after endovascular femoral artery revascularization: The Boston femoral artery endovascular revascularization outcomes (Boston FAROUT) study
Abstract
Methods
We assessed
adverse outcomes in patients after an index revascularization stratified by age (age < 65, 65–75 years, and > 75 years) from two centers between 2003 and 2011 and followed a median 9 (25 %–75 %: 7, 11) years. Outcomes included major adverse limb events (MALE) or minor repeat revascularization, death, and major adverse cardiac and cerebrovascular events (MACCE). We used cause-specific and competing-risks analyses with clustering by patient to determine the hazard ratios (HR), sub-hazard ratios (SHR), 95 % confidence intervals (95%CI) for outcomes according to older age.
Results
There were 253 limbs revascularized in 202 patients with a high use of lipid lowering therapy (91 %) and
aspirin anti-platelet therapy (96 %). In oldest age group (>75 years), 71 limbs were revascularized and patients were less likely to be active smokers and had poorer tibial runoff than younger patients. In competing risks multivariable models, patients >75 years old had similar risks over 10 years of MALE or minor revascularization (SHR = 0.92, 95%CI = 0.53, 1.62) and MACCE (SHR = 1.12, 95%CI = 0.58, 2.18) to younger patients. All-cause death was more common in older patients (HR = 1.99, 95%CI = 1.25, 3.17).