Vascular surgery

In addition to the anatomic and reconstructive objectives of vascular surgery, a geriatric medicine approach to vascular surgery in the elderly includes prevention of untoward events while maintaining independence and quality of life. Intervening to prevent future stroke and aortic rupture or maintaining independence by limb salvage or improving ambulatory function are the primary goals of the vascular surgeon. With the increasing age of our population, vascular surgeons must be at the forefront of insuring excellent care for seniors through knowledge of specific geriatric risk factors indicative of poor outcomes. This chapter will examine general considerations for elderly vascular patients with regard to indications and outcomes for the elderly patient and explore the increasingly recognized syndrome of frailty as perhaps the strongest predictor of outcomes in vascular surgical patients.