The mortality rate after open or endovascular AAA repair in carefully selected octogenarians seems acceptable but is higher than the mortality rate in younger patients. Long-term survival rates were acceptable, but small sample size, selection, and publication bias must be taken into account. Finally, selection criteria for successful surgery with low mortality and morbidity rates cannot be derived from the literature.
We found some evidence for a relation between the volume of AAA surgery and peri-operative mortality. There seems to be a nonsignificant trend in favour of high volume hospitals. However we could not derive an unequivocal volume threshold for safely performing AAA surgery.
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