Outcome of elective treatment of abdominal aortic aneurysm in elderly patients

Abstract

Long-term outcome after EVAR procedures results in higher mortality rates for the population older than 80 years as compared to the group aged 70-79 years.

Predicting failure to rescue after abdominal aortic aneurysm repair in elderly patients

“…Not surprisingly, this rate is relatively high compared to that of previous studies on this topic. 2,7,16 For example, Illonzo et al found that the rates of FTR following OAR and EVAR in a Medicare population were 1.6% and 5.0%, respectively. 16 Given that advanced age has been associated with greater risk of FTR following injury, cholecystectomy, transurethral prostatectomy, and cardiac surgery, 9,13,16,17 it follows that the rate of FTR following AAA in the elderly would be higher than that seen in the general population.…”

“…6 Given these findings, it is imperative that surgeons weigh the risks of AAA repair compared to the risks of medical management in older patients with AAA. 2,[30][31][32] This is especially true given that the number of elderly patients is on the rise, which means that the number of elderly patients who meet the 5.5 cm criterion for AAA repair will be increasing as well. 5,15 Although our analysis is not designed to propose an age-specific diameter criteria for AAA repair, the increased risk of FTR that we observed among elderly patients suggests that the size threshold for repair should probably be adjusted in older patients.…”

“…To prevent rupture, the current standard of care is to repair AAAs when the aneurysm diameter exceeds 5.5 cm. 1,2 Such repairs can be performed through either an open (OAR) or endovascular (EVAR) approach.…”

Abdominal aortic aneurysm repair in octogenarians is associated with higher mortality compared with nonoctogenarians

“…6 Although some studies suggest that this risk is not prohibitive to operative intervention, others suggest that, in many cases, it is. [7][8][9][10] In contrast, nonoperative management of AAA within the older population also carries a substantial risk of death. Two-thirds of AAA ruptures have been demonstrated to occur in patients aged $75 years, with a resulting estimated 30-day mortality risk of 69%.…”

A Majority of Admitted Patients With Ruptured Abdominal Aortic Aneurysm Undergo and Survive Corrective Treatment: A Population‐Based Retrospective Cohort Study

“…Age has always been reported to be an influential factor when outcome is evaluated in surgical series [1, 22, 27, 31, 32]. It is clear that the number of aged patients is high among the untreated in this and other series.…”