The study, published in the American Journal of Surgery, looked at patients 90 or older who underwent vascular surgeries such as open-heart surgery, angioplasty, embolectomy and others. M. Ashraf Mansour, MD, head of vascular surgery at Spectrum Health Medical Group in Grand Rapids, Mich., was one of the lead authors of the study and looked at 176 patients who received vascular procedures between 1996 and 2010.
Dr. Mansour first noted the conventional wisdom surrounding older patients and whether they should have in-depth procedures. “There is the prevailing sentiment, which is probably true in most cases, that as patients get older, they are sicker and therefore more brittle, more vulnerable or more prone to complications from procedures,” he says. Secondly, Dr. Mansour says vascular surgery is a fairly invasive line of work. Open-heart surgeries, chest surgeries and surgeries to remove cancerous tumors are all larger operations, but there’s also been a shift in the past few years toward lesser invasive surgeries. For example, these types of endovascular operations tackle abdominal aortic aneurysms or narrowed coronary arteries.
With those things in mind, Dr. Mansour and his colleagues looked at the sample of patients who underwent life- or limb-saving procedures. They discovered that morbidity and mortality rates were comparable to younger patients who underwent similar surgeries, and many patients also recovered from their surgery to their preoperative, functional state. The conclusion? Don’t let age dictate vascular procedures.
“When people reach 90, their life expectancy is better than the average American anyway,” Dr. Mansour says. “If you passed that milestone, chances are you are going to live a little longer. The myth that you’re 90 and will die anytime and should avoid surgery at all costs is wrong.”
For the first five or so years of the study sample, Dr. Mansour says all patients underwent open incision surgeries, but today’s advances in endovascular and minimally invasive surgeries allow physicians to be even more careful with patients who might fear surgery will only regress their physical conditions. And with the upcoming influx of Baby Boomers, Dr. Mansour says this will become an even bigger issue.
“People are learning how to take care of themselves, so they are living a healthy and longer life,” Dr. Mansour says. “As this happens across the board, more and more patients in their 90s are going to need medical attention. These people are going to be offered the opportunity to go through an operation, and most of the time, they are going to do just fine.”
Related Articles on Vascular Surgery:
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