Endovascular repair of abdominal aortic aneurysm in octogenarians: An analysis based on EUROSTAR data

Abstract

Our study supports that EVAR might be considered when treating elderly patients, provided their aneurysms are anatomically suited for the endovascular technique. The risk for late complications compared with open repair may be outweighed by a lower early mortality as well as a shorter time for physical recovery.

Predictors of outcome after elective endovascular abdominal aortic aneurysm repair and external validation of a risk prediction model

“…These associations were expected and have been reported previously. [17][18][19][20][21] Nevertheless, the influence of the ASA score on midterm survival among RBWH patients was notably strong, with 5-year survival rates for ASA 2, 3, and 4 individuals of 90.5%, 64.3%, and 23.1%, respectively. Similarly, Boult et al 17 found the ASA score was the most powerful predictor of midterm survival among the ASERNIP-S audit patients.…”

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

“…However, recent actuarial studies have shown that a person alive at 80 can expect to live for another 9.5 years while a person alive at 90 can expect to live another 5 years [10], making a conservative approach for symptomatic arterial disease unpalatable for most elderly patients. Ironically, elective operation is the most important measure to prevent post-operative morbidity and mortality (particularly in AAA disease) [11] and conservatism may lead to older patients not being treated early enough, thus presenting as an emergency [12]. This prompted us to analyse our approach to management of elderly patients and to compare our complication rates in our open and endovascular cases between the elderly patients and younger cohort, ultimately to determine whether we should use age as an influential factor in making a management decision.…”

Endovascular Aneurysm Repair in Nonagenarians: A Systematic Review

“…8,9 There are many reports with large numbers of patients suggesting that EVAR in octogenarians is acceptably safe and effective. 3,10,11 Some observational studies do report successful management of nonagenarians with AAA using EVAR, but such reports tend to report few cases, and thus, it is difficult to draw reliable conclusions. 12,13 In addition, a true successful outcome from EVAR should be interpreted with reference to the alternative outcome under conservative management.…”