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109 subjects aged 70 years (58 women, 51 men; average age 77 years) were hospitalized in the CICU (Cardiology Intensive Care Unit) over the period stretching from 1984 to 1986. The average length of stay in the CICU was 1 week, completed by an average stay of 5 days in the cardiology department. 100 per cent of the patients were followed up. Of the clinical parameters made evident by this study, the authors note that hypertension was the predominant risk factor (52.2 per cent); a history of coronary disease was noted in 60.5 per cent; 26.6 per cent of the patients were hospitalized before the 6th hour, chest pain being typical in 78 per cent versus painless in 11 per cent of patients; topographically, the infarction was anterior in 55 per cent, posterior in 40.4 per cent, and around the circumference in 4.6 per cent of cases; 80.8 per cent of the infarctions were transmural versus 19.2 per cent of infarctions without the Q wave--the latter accounted for a higher hospital mortality rate (38 per cent versus 27.3 per cent). The main complications were disturbances in rhythm (60.6 per cent) and LVI (56.9 per cent). Complications on the form of infections were noted in 15.6 per cent. Apart from the usual indicators of severity (cardiogenic shock, VF, LVI), infarction of the RV and AF had a serious effect on the prognosis. latrogenic disease accounted for 18.9 per cent. From the point of view of prognosis, hospital mortality was 30 per cent; mortality after one year was 44 per cent and 47.7 per cent after 2 years (in a group of 76 subjects).(ABSTRACT TRUNCATED AT 250 WORDS)

Case reports of 176 patients from a total of 385 operated upon for arteritis, and in the over 70 age group, were analyzed; operations for sympathectomy and to treat ruptured aortic aneurysms were excluded from the study. Of particularly poor prognosis were cases of acute ischemia and very severe ischemia requiring immediate amputation. In a general manner, amputations were of poor prognostic significance: in comparison, reconstructive surgery resulted in a lower mortality rate. Figures for mortality as a function of age showed that recovery surgery is often possible in patients of 80 or over. Moderate-term results were good in from 55.5% to 80.9% of cases as a function of type of operation performed. Continued progress during the 5-year period covered by this study has led to diminished mortality and a reduction in the number of amputations necessary.

A retrospective study of 108 case-reports of patients treated by lumbar sympathectomy was conducted to determine irrigraphic parameters possessing possible predictive value for the indication of sympathectomy. The value of the Index 6 (distal irrigation index) must be certainly taken into account; the Index 1 (proximal index) appears to be of interest when analyzing data with a view to sympathectomy in diffuse forms of arteritis. Three profile-types were distinguished; statistical analysis showed no significant difference in these profiles, with respect to the sympathectomy, in relation to the clinical results obtained. Irrigraphic modifications after sympathectomy were analyzed in 72 cases; results confirmed the improved efficacy of sympathectomy at Stage 2 than at Stages 3 and 4, but also showed that at Stage 2 the profile II appeared to react more favorably and that at Stages 3 and 4 the profile I appears to react less well than the other profiles. Also studied were patients with diabetes, who react less favorably to sympathectomy, patients who fail-to respond to sympathectomy, and those with worsening of irrigraphic profiles after sympathectomy, mainly in diabetics with profile I. These findings show that it is not possible to define a precise irrigraphic profile more favorable to sympathectomy, but that they provide interesting elements to be confronted with clinical and arteriographic data when deciding on the need for sympathectomy.

The 50s represent a hinge age-period during which atherosclerosis is more frequent but arterial disease does not appear to present features differing from those observed in neighbouring age groups. There is of course a higher frequency of atherosclerotic lesions of other arterial territories and a fairly high incidence of diabetes. With respect to the latter disease, apart from the typical association arteritis-diabetes, some cases are simply of atherosclerosis developing at the same time as the diabetes. Arteritis of lower limbs can present as two principal types in patient in their 50s: elective aorto-iliac arterial disease similar to early onset atherosclerosis in younger patients and more diffuse forms more typical of arterial disease in the elderly.