[Elderly patients with chronic limb-threatening ischemia: conservative treatment is appropriate care within an evolving healthcare landscape].

Authors

Bob T A Schultze, B J M Nardo van der Meer, Lijckle van der Laan

Published in

Nederlands tijdschrift voor geneeskunde. Volume 170. Aug 03, 2026. Epub Aug 03, 2026.

Abstract

Revascularization remains the cornerstone of treatment for CLTI. Conservative treatment represents an underexposed yet potentially appropriate alternative for selected elderly and frail patients. This population is characterized by high mortality rates, substantial perioperative risks, prolonged hospital stays, increased healthcare costs, and deterioration in functional status and quality of life following invasive interventions. Conservative treatment - including wound care, pain management, and when necessary, minor amputations - may offer an alternative for frail, elderly patients with CLTI. Emerging evidence suggests that, for selected patients, conservative treatment can result in acceptable wound healing rates and survival comparable to invasive strategies, without an increase in major amputation rates. Within the context of appropriate and value-based care, conservative treatment may better balance functional outcomes, healthcare utilization and patient preferences. Future research on prediction models to guide patient selection, cost-effectiveness analyses, and qualitative studies exploring patient-reported outcomes and experiences, should support evidence-based implementation of conservative treatment.

PMID:
42565292
Bibliographic data and abstract were imported from PubMed on 07 Aug 2026.

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