Outcome of elective endovascular abdominal aortic aneurysm repair in octogenarians and nonagenarians

Prenner, Stuart B.; Turnbull, Irene C.; Malik, Rajesh; Salloum, Alexander; Ellozy, Sharif H.; Vouyouka, Angeliki; Marin, Michael L.; Faries, Peter L.

doi:10.1016/j.jvs.2010.01.030

Cited by 43 publications

(37 citation statements)

References 20 publications

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“…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.…”

Section: Discussionsupporting

confidence: 89%

“…Further investigations or pre-operative interventions were carried out as necessary. Fifty-eight percent of our octogenarian population survived beyond 5 years, which compares favourably with general life expectancy amongst the population in our region although it is notably less than the 64 -92% 5-year survival reported in other studies (3,4,11,12).…”

Section: Discussionsupporting

confidence: 49%

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Survival Following Endovascular Aneurysm Repair in the Octogenarian

Pang¹

2017

AVS

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Survival following elective Endovascular Aneurysm Repair (EVAR) in the OctogenarianAim: Increasing age is a recognized independent predictor of mortality in aneurysm surgery. However, the long term survival benefit in octogenarians following Endovascular Aneurysm Repair (EVAR) remains unclear despite supporting evidence of safe use. Methods:Consecutive subjects who underwent elective EVAR for AAA in a single tertiary centre between 1 st July 2000 and 31 st January 2015 were identified and survival data extracted through hospital electronic records. Subjects were categorized into two cohorts based on age, Group 1 (G1): < 80 years and Group 2 (G2): ≥80 years. Primary endpoints of interest were (i) 30-day mortality; (ii) early and late aneurysm related deaths; (iii) overall survival at follow up at 31 March 2015.Results: 266 patients (235 male, 88.3%) were included in the study. G1 comprised 195 patients (180 male, 92.0%), mean age 71.9 years (Standard Deviation (SD) 5.7) whilst G2 comprised 71 patients (55 male, 77%), mean age 83.2 years (SD 2.1).The mean AAA sac diameter were similar between groups (6.5cm v 6.3cm, p > 0.05). G2 had higher proportion of patients with chronic kidney disease (32% v 12%, p < 0.001). Thirty-day mortality: 3 deaths occurred in G1 and 1 in G2. The odds ratio for octogenarians developing post-operative 30-day complications was 1.99 (95% confidence interval (CI) 1.11-3.61, p = 0.02).At follow up, 81 deaths occurred (G1: 55, G2: 26). Overall median survival was 91 months (Standard Error (SE) 4.6). Median survival in G1 = 92 (SE 16.6) months and G2 = 87 (SE 14.8) months. No survival differences were observed between groups on Kaplan Meier analysis (Log Rank, p > 0.05). Multivariate Cox proportional hazards model demonstrated that ASA scores more than 3 significantly predicted risk of mortality during follow up with hazard ratio of 3.97 (95% confidence interval 2.06 -7.65). Conclusion:Survival of selected octogenarian patients undergoing elective EVAR is comparable to younger co-hort of patients undergoing EVAR.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 49%

Survival Following Endovascular Aneurysm Repair in the Octogenarian

Pang¹

2017

AVS

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“…Kazmers et al have shown that open aneurysm repair may be beneficial in octogenarians despite the increased mortality associated with their age. 2,3 Furthermore, more recent studies have reported the feasibility of endovascular AAA repair in the elderly. 4e8 Most of these reports, however, have been single institution studies, with results not necessarily generalizable to the entire nation.…”

Section: Introductionmentioning

confidence: 99%

Abdominal Aortic Aneurysm Repair in Nonagenarians

Hughes

Hamdi

Prendergast

et al. 2015

Annals of Vascular Surgery

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“…They concluded that EVAR in octogenarians is associated with high procedural success and low perioperative morbidity and mortality. 38 In the Nonagenarian population Halpern et al report the largest retrospective review of EVAR over a 10-year period. While this remains a small cohort of only 23 patients.…”

Section: The Elderlymentioning

confidence: 99%

“…Their results demonstrated EVAR in octogenarians is associated with low rates of perioperative morbidity and mortality and low long-term aneurysm-related mortality despite the high rates of comorbidities in these patients. 38 …”

Section: Octogenarians-to-nonagenariansmentioning

confidence: 99%