Outcomes of intact thoracic endovascular aortic repair in octogenarians

Dakour-Aridi, Hanaa; Yin, Kanhua; Hussain, Farooq; Locham, Satinderjit; Azizzadeh, Ali; Malas, Mahmoud B.

doi:10.1016/j.jvs.2021.01.039

Cited by 13 publications

(12 citation statements)

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“…14,15 Early diagnosis and elective management of TEVAR in elderly patients can help mitigate the surgical risk and poor outcomes seen in the emergent setting. 14,15…”

Section: Introductionmentioning

confidence: 99%

“…Compared to younger patients, elderly patients demonstrate a three to five times greater mortality risk in settings of urgent or emergent TEVAR. [13][14][15] Increased risks of emergent TEVAR in elderly patients have been associated with greater incidences of hematomas, dysrhythmias, and extracardiac arteriopathies in comparison to younger patients. 14,15 However, octogenarians undergoing TEVAR for non-ruptured thoracoabdominal aneurysm or dissections are shown to have comparable mortality and morbidity rates to younger patient populations.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15] Increased risks of emergent TEVAR in elderly patients have been associated with greater incidences of hematomas, dysrhythmias, and extracardiac arteriopathies in comparison to younger patients. 14,15 However, octogenarians undergoing TEVAR for non-ruptured thoracoabdominal aneurysm or dissections are shown to have comparable mortality and morbidity rates to younger patient populations. 14,15 Early diagnosis and elective management of TEVAR in elderly patients can help mitigate the surgical risk and poor outcomes seen in the emergent setting.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 However, octogenarians undergoing TEVAR for non-ruptured thoracoabdominal aneurysm or dissections are shown to have comparable mortality and morbidity rates to younger patient populations. 14,15 Early diagnosis and elective management of TEVAR in elderly patients can help mitigate the surgical risk and poor outcomes seen in the emergent setting. 14,15 Although data in support of elective TEVAR in the elderly population is growing, little is known about the peri-operative morbidity and mortality rates in this population.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 Early diagnosis and elective management of TEVAR in elderly patients can help mitigate the surgical risk and poor outcomes seen in the emergent setting. 14,15 Although data in support of elective TEVAR in the elderly population is growing, little is known about the peri-operative morbidity and mortality rates in this population. While singleinstitution studies, including high-volume centers, have assessed TEVAR outcomes in elderly patients, their conclusions were drawn from small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Thoracic Endovascular Aortic Repair in Octogenarians

Alnahhal

Narayanan

Lingutla

et al. 2021

Vasc Endovascular Surg

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Objective The aim of this study is to compare outcomes between octogenarians and non-octogenarians undergoing thoracic endovascular aortic repair (TEVAR). Methods Using the National Inpatient Sample database, we identified octogenarians (≥80 years) and non-octogenarians (<80 years) who had undergone thoracic endovascular aortic repair between 2012 and 2017. We compared patients’ demographic, socioeconomic, comorbidity data between the two groups as well as the procedure indications and perioperative outcomes. A multivariable logistic regression analysis was conducted to evaluate the impact of advanced age (≥80 years) on the in-hospital mortality rates in patients who underwent TEVAR. This analysis was also performed for a separate cohort which included only patients who underwent TEVAR for ruptured thoracic aortic aneurysm. Results A total of 4108 patients were included in our study; 3432 (83.5%) patients were <80 years (37.9% female; median age, 64 years; 34.3% non-white) and 676 (16.5%) patients were ≥80 years (50.7% female; median age, 83 years; 20.4% non-white). Non-ruptured thoracic aortic aneurysm was the most common indication for TEVAR in older patients (61.4%), whereas type B aortic dissection was the most common indication in younger patients (36.4%). In-hospital complications were comparable between the two groups except for respiratory complications that were higher in the younger patients (21.2% vs. 15.2%; P <.001). The multivariable analysis demonstrated that advanced age had no association with increased in-hospital mortality rates (adjusted odds ratio [aOR], 1.41; 95% confidence interval [CI], .97-2.05), However, in ruptured thoracic aortic aneurysm cohort, octogenarians had higher in-hospital mortality rates (aOR, 1.86; 95% CI, 1.04-3.32). Conclusions Octogenarians have acceptable rates of perioperative morbidity and mortality compared to the younger group and should be considered for TEVAR. Octogenarians are at higher risk for in-hospital mortality in the setting of ruptured thoracic aortic aneurysm, supporting the appropriateness of elective TEVAR in selected Octogenarians.

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“…14,15 Early diagnosis and elective management of TEVAR in elderly patients can help mitigate the surgical risk and poor outcomes seen in the emergent setting. 14,15…”

Section: Introductionmentioning

confidence: 99%