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

Objective: to examine the association between the incidences of infrapopliteal bypass for critical limb ischaemia (CLI) and major amputation in Finns aged greater than or equal to70 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 greater than or equal to80, but not <80 years. Conclusions: these results suggest that infrapopliteal bypass is effective in reducing the requirement for major amputation in patients aged >80 years.