Vascular disease in the elderly patient

At a time of potentially dramatic changes in health care policy in this country, and in view of the necessity for health care cost containment, physicians are expected to exercise serious introspection in the selection of treatment for the elderly patient with peripheral arterial disease. These decisions should be made while acknowledging that it is the goal of the health-care provider 'to postpone chronic illness, to maintain vigor, and to slow social and psychological involution.' For the elderly patient with an abdominal aortic aneurysm, with significant carotid disease, or with limb- threatening peripheral ischemia, the evidence is compelling that timely surgical intervention in properly selected patients is well tolerated and will satisfy this goal.