Outcomes of Endovascular Abdominal Aortic Aneurysm Repair in Octogenarians: Meta-analysis and Systematic Review

Han, Yanshuo; Zhang, S.; Zhang, J.; Ji, Chao; Eckstein, Hans‐Henning

doi:10.1016/j.ejvs.2017.06.027

Cited by 65 publications

(65 citation statements)

References 33 publications

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“…Han et al in a recent meta-analysis reported a higher rate of comorbidities and higher ASA class (3) in the octogenarian population. 1 The present study did not find any difference between the groups concerning different ASA classes, but higher ASA class (4) was an independent predictor of early all cause mortality, independent of age. A modified frailty index was recently suggested as a better discriminator of mortality than other risk factors, especially age and comorbidities.…”

Section: Discussioncontrasting

confidence: 65%

Early Outcomes After Branched and Fenestrated Endovascular Aortic Repair in Octogenarians

Makaloski

Kölbel

Rohlffs

et al. 2018

European Journal of Vascular and Endovascular Surgery

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Section: Discussioncontrasting

confidence: 65%

Early Outcomes After Branched and Fenestrated Endovascular Aortic Repair in Octogenarians

Makaloski

Kölbel

Rohlffs

et al. 2018

European Journal of Vascular and Endovascular Surgery

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“…4,11,17,18 A recent metaanalysis pooled the results of 8 surgical series and reported a perioperative mortality rate of 3.73% in 5876 patients. 19 In contrast, younger patients had perioperative mortality rates of 0%-1.68%. [17][18][19] All patients who died perioperatively in the current study presented with ruptures, which inherently increased their mortality risk.…”

Section: Discussionmentioning

confidence: 99%

“…19 In contrast, younger patients had perioperative mortality rates of 0%-1.68%. [17][18][19] All patients who died perioperatively in the current study presented with ruptures, which inherently increased their mortality risk. Additionally, the average survival time in this series was 58 months, which is substantial given that the average life expectancy in Canada is 82 years and the average age at intervention is 84 years.…”

Section: Discussionmentioning

confidence: 99%

“…The present paper included patients whose baseline characteristics were similar to those of patients in other published papers exploring outcomes in octogenarians. 1,[16][17][18][19] Although the goal of elective repair is to prevent fatal rupture, this benefit must be weighed against the risks associated with the procedure and anesthetic. Mortality rates for elective AAA repair range from 1.2% to 7%.…”

Section: Discussionmentioning

confidence: 99%

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Endovascular repair of abdominal aortic aneurysm in octogenarians: clinical outcomes and complications

Raju

Eisenberg

Montbriand

et al. 2020

CJS

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Background: Endovascular aneurysm repair (EVAR) is associated with decreased perioperative morbidity and mortaliy in comparison with open repair, and thus octagenarians are traditionally offered EVAR given their age and medical comorbidities. The aim of this study was to investigate outcomes and predictors of complications associated with EVAR in octogenarians. Methods: We conducted a retrospective chart review of consecutive patients aged 80 years and older who received an EVAR between August 2010 and January 2017 at a single centre in Toronto, Ontario. We conducted univariate comparisons and then completed logistic regression to determine predictors of complications. We used Kaplan-Meier analysis to explore survival times. Results: A total of 154 octogenarians underwent an EVAR during the study period for an infrarenal aneurysm with a mean size of 64.8 (standard deviation [SD] 12.7) mm. The mean age of the patients was 84.1 (SD 3.7) years, and most patients (81%) were men. Eighteen patients presented with a ruptured abdominal aortic aneurysm (AAA). Ninety-five (62%) patients sustained a complication. Fifty percent of patients experienced an intraoperative complication. A majority of these (77%) resulted in an endoleak, with type II endoleaks requiring no further intervenion being the most common (58%, n = 45). The remaining complications (n = 70) occurred postoperatively, with myocardial ischemia (n = 24) and dysrhythmias (n = 10) being the most common. Past aortic surgery (χ 2 = 8.62, p = 0.014, Cramer V = 0.27) was found to be a multivariate predictor of complications. Most patients (88%) continued follow-up to an average of 20.9 months. Twenty-one patients (13%) died. Nine of these deaths (43%) occurred during the index admission and involved a ruptured AAA. Past aortic surgery was the only predictor of vascular complications. The mean survival time after EVAR was 57.63 months for patients without events. Conclusion: Endovascular aneurysm repair in octogenarians is a suitable form of therapy with acceptable short-and long-term results in the elective setting. Past aortic surgery was a predictor of complications in this population. Contexte : La réparation endovasculaire de l'anévrisme (REVA) est associée à une diminution de la morbidité et de la mortalité périopératoires comparativement à la chirurgie ouverte, c'est pourquoi on offre habituellement la REVA aux octogénaires, compte tenu de leur âge et de leurs comorbidités. Le but de cette étude était d'analyser l'issue de la REVA et les prédicteurs de complications chez les octogénaires. Méthodes : Nous avons procédé à une analyse rétrospective des dossiers de patients de 80 ans et plus consécutifs soumis à une REVA entre août 2010 et janvier 2017 dans un établissement de Toronto, en Ontario. Nous avons effectué des comparaisons univariées, puis une analyse de régression logistique pour dégager les prédicteurs de complications. C'est l'analyse de Kaplan-Meier qui a permis d'explorer la survie. Résultats : En tout, pendant la période de l'étude, 154 octogénai...

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“…For mid-term follow-up outcomes, which of these issues are equivalent for octogenarians AAAs who underwent EVAR compared with younger AAA patients after EVAR? 9 A. Reintervention rates B. All cause mortality C. Aneurysm-related death D. Aneurysm rupture rate E. Aneurysm growth rate…”

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confidence: 99%

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2018

European Journal of Vascular and Endovascular Surgery

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is the most common complication after deep venous stenting? 1 A. Occlusion B. Stenosis C. Allergy to contrast agent D. Bleeding E. Infection 2. Which of the following was associated to aneurysm growth in the study by Ghulam et al? 2 A. Body Mass Index B. Smoking C. Diabetes mellitus D. Hypertension E. Sex 3. Which one of the following statements is true for patients with IVC thrombosis? 3 A. IVC filter is necessary to prevent pulmonary embolism in patients with IVC thrombosis. B. Anticoagulation is the mainstay treatment for patients with IVC thrombosis. C. Stent placement should be performed primarily to relieve symptoms in patients with IVC thrombosis. D. Active malignancy is one of the contraindications to thrombolysis in patients with IVC thrombosis. E. The incidence of pulmonary embolism is high during thrombolysis for patients with IVC thrombosis.

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Outcomes of Endovascular Abdominal Aortic Aneurysm Repair in Octogenarians: Meta-analysis and Systematic Review

Cited by 65 publications

References 33 publications

Early Outcomes After Branched and Fenestrated Endovascular Aortic Repair in Octogenarians

Early Outcomes After Branched and Fenestrated Endovascular Aortic Repair in Octogenarians

Endovascular repair of abdominal aortic aneurysm in octogenarians: clinical outcomes and complications

One year on: Test your knowledge from the previous year

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