Key result
Age ≥80 years linked to a ~3-fold increase in mortality after endovascular PAD therapy.
Why the study?
Do outcomes of endovascular therapy for symptomatic PAD differ between octogenarians/older patients and younger patients?
Observational (n=7,171)
Yes
Do outcomes of endovascular therapy for symptomatic PAD differ between octogenarians/older patients and younger patients?
Answers are grounded in this paper and cite their sources.
Octogenarians and older patients undergoing endovascular therapy for PAD have higher rates of mortality, amputations, and access site complications compared to younger patients, emphasizing the need for age-specific risk assessment.
Background The prevalence of symptomatic peripheral artery disease (PAD) increases rapidly with age and for elderly patients the preferred revascularization strategy is endovascular treatment. However, evidence concerning current endovascular treatment patterns and outcomes in elderly patients are still scarce. We sought to analyze characteristics, contemporary treatment patterns and outcomes of elderly patients in a nationwide, multicenter registry. Methods Patients who had peripheral interventions for symptomatic PAD in the RECcording COurses of vasculaR Diseases (RECCORD) registry between 2017 and 2024 were included. The primary outcome was all-cause mortality, and secondary outcome measures included amputations, changes in Rutherford class and periprocedural complications. For the evaluation of endovascular therapy in elderly patients, we focused on the comparison of octogenarians and older patients with younger patients. Results A total of 7171 patients (mean age 72.3 ± 10.2 years, 35.4% female) with PAD that underwent 12.815 interventional revascularizations were analyzed. 1980 patients were aged 80 years and older (mean age 84.8 ± 3.9 years, 47.5% female). Octogenarians presented with more comorbidities than younger patients and were more likely to present with CLTI. Older patients had a higher mortality (8.8% vs. 2.9%, p<0.001), with more frequent access site complications (3.7% vs. 2.9%, p=0.04) and more amputations (4.1% vs. 2.9%, p=0.04). Conclusion Our data demonstrate that octogenarians and older patients undergoing endovascular therapy present with an aggravated clinical status, and entail a higher rate of access site complications, amputations and mortality. This highlights the importance of age-specific risk assessment in clinical decision-making and peri- and postinterventional follow-up of this multimorbid cohort.
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Pinsdorf et al. (2025) conducted an observational in symptomatic peripheral artery disease (n=7,171). Age ≥80 years vs. Age <80 years was evaluated on all-cause mortality (p=<0.001). Age ≥80 years was associated with significantly higher all-cause mortality compared to younger patients following endovascular therapy for peripheral artery disease (8.8% vs. 2.9%, p<0.001).
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