Endovascular repair of aortic abdominal aneurysms in octagenarian patients: early and midterm results
Nano, G.; Bianchi, P.; Stegher, S.; Malacrida, G.; Cazzaniga, M.; Trimarchi, S.; Rampoldi, V.; Tealdi, D.G.
Annali Italiani di Chirurgia 79(5): 335-339; Discussion 340
2008
ISSN/ISBN: 0003-469X PMID: 19149361 Document Number: 619044
This article summarizes our experience in endovascular repair of abdominal aortic aneurysm in octogenarian patients. From January 2000 to December 2005 30 patients (mean age 84 years) underwent endovascular repair of abdominal aortic aneurysm; in 28 cases a loco-regional anaesthesia has been performed. Twenty-eight bifurcated graft, one straight graft and one aorto-iliac graft have been used. No operative mortality or early endoleak have been observed; during the follow-up period (20 months) 7 endo-leaks (3 cases type I; 4 cases type II) have been reported; all patients with type I EL underwent endovascular repair; in two patients with type II EL we observed spontaneous regression; the other cases are still monitored in absence of sac enlargement. Four graft occlusions have been observed; one early thrombosis has been treated with surgical thrombectomy, two of the three late occlusions required other procedures. Five patients died during the follow-up period, three of them during the first year. No death has been aneurysm related. In accord with other recent studies, our analysis confirms the positive impact on intra-operative and early post-procedural mortality of the endovascular therapy for abdominal aortic aneurysm in octogenarian patients; no evidence of significative benefit on late survival has been observed. In conclusion we consider endovascular option as the best approach in octogenarian patients even if a longer follow-up is mandatory.