[A year's practice of surgery for arteritis after the age of 70 years (author's transl)].

Surgery of the elderly arteritic raises the problem of operative risk due to pre-existing defects at an advanced stage of the arterial disease and the danger of tiring investigations, anesthetics and repeated operations. Out of 271 arteritics operated on during 1975, half (135) were aged over 70 years. 92, i.e. two thirds were operated on at the terminal stage of their arteritis. The operative indications depended on the clinical, arteriographic, psychological and sociological data. The past history in many cases of heart attacks and cerebro-vascular accidents made the utility and necessity of the operation debatable. The technical choice, sympathectomy or plastic operation, depended on which presented the less risk. Although amputation is still necessary for massive gangrene (50 p. cent survival) one should always attempt to save the leg. Lumbar sympathectomy seems less aggressive; reconstructive surgery is, with greater risk, more effective at stage IV. The final result of the year showed 72.6 p. cent survivors including 56.3 p. cent successes and 16.3 p. cent amputations and a mortality of 27.4 p. cent. But all the failures were situated at stage IV of the arteritis, and the disturbances are increased by the patients' age. We can thus say that it is possible to render survival comfortable for three quarters of our operated patients.