Elective surgery of abdominal aortic aneurysms in octogenarians: A systematic review

Abstract

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.

Acceptable Risk but Small Benefit of Endovascular Aneurysm Repair in Nonagenarians

“…16 Despite the uncertainty and overall concern regarding age, numerous articles have reported acceptable results for octogenarians treated with both open and endovascular techniques. Henebiens et al 17 concluded that the mortality rate, while higher than in younger patients, is acceptable in carefully selected octogenarians. In contrast, the published literature on nonagenarians remains limited (Table I).…”

An analysis of vascular surgery in elderly patients to determine whether age affects treatment strategy

“…Several papers have questioned whether patient age itself independently predicts morbidity in elderly surgical patients, rather than the burden of comorbidity [13,14]. Many vascular operations show similar morbidity and mortality rates in fit elderly patients and young patients [15][16][17]. Risk-benefit analysis in the elderly patient, therefore, remains the cornerstone of proper patient selection.…”

Abdominal Aortic Aneurysms: Changing Paradigms in Treatment

“…Open repair of AAAs in octogenarians has been associated with increased life expectancy in comparison to untreated AAAs 35 . With respect to treatment of AAA mortality rate, while higher than in younger patients, is acceptable in carefully selected octogenarians 36 . While other investigators looking at EVAR vs. Open repair concluded that there was no difference in the long-term survival benefit between open repair www.intechopen.com and EVAR in 150 octogenarians.…”