Intermediate-term EVAR outcomes in octogenarians

Abstract

EVAR can be performed safely and effectively in octogenarians, and the incidence of major complications including myocardial infarction, stroke, and death is unchanged compared with younger patients. However, there is a significantly increased rate of access-site hematomas, pulmonary, and perioperative complications in octogenarians as a whole. Our findings suggest EVAR remains a suitable form of therapy in the elderly group provided there is an appropriate preoperative evaluation and perioperative monitoring following repair.

Endovascular repair of infrarenal aortic aneurysms in octogenarians and nonagenarians

“…Reported mortality rates for octogenarians after EVAR in larger series vary between 1% and 5% and are thus in line with our results (3.2%). [10][11][12][13][14] Consistent with our findings, these series describe cardiopulmonary complications as the predominant cause of perioperative death, which underlines the necessity for a rigorous preoperative cardiopulmonary evaluation and optimization of the patients. Cardiac (3.2%) and renal (2.8%) complications in our series are both within the reported range of the literature (1.7% to 7.5% for cardiac complica- tions and 3.5% to 6% for renal complications).…”

“…In this series, anemia was present in 42% of the patients and preoperative or postoperative transfusion of red blood cells was necessary in a high proportion of patients (17%), a finding confirmed by other series. 11 We have previously proven anemia to be associated with aneurysm size and decreased long-term survival after EVAR, and this series also suggests the role for anemia as a risk stratification tool in elderly patients with AAA. 19,20 Given the demographical development in most industrial countries, there is no doubt that more and more elderly patients with AAAs will seek treatment in the future.…”

“…Cardiac (3.2%) and renal (2.8%) complications in our series are both within the reported range of the literature (1.7% to 7.5% for cardiac complica- tions and 3.5% to 6% for renal complications). 11,12 However, we observed a lower rate of pulmonary complications (1.8%) than reported in the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EU-ROSTAR) analysis (4.5%) and the series by Fonseca et al 11 (5.1%). Two factors might have contributed to this result.…”

Survival Following Endovascular Aneurysm Repair in the Octogenarian

“…Building on this, one observation noted in our study is the higher proportion of female within the octogenarian group. This shares the observation of others in the literature [10,11]. At a superficial level, this may simply represent an upward trend of AAA in female octogenarians.…”

Elective endovascular vs. open repair for abdominal aortic aneurysm in octogenarians

“…[4][5][6][7][8]12,[15][16][17][18][19][20][21][22][23][24][25] In this study, the incidence of CAD was 33.8%. The percentage of CAD varies by reports or countries, 21-33.3% in Japan 20,23 and 34-69% in US, [5][6][7][8]16,24,25 which may be caused by the difference of the lifestyle. However, as the rate of aging and westernization of the life style has accelerated in Japan, the incidence of acute coronary syndrome has been increased over 30 years.…”