title: Impact of endovascular repair for abdominal aortic aneurysms in octogenarians.
abstract: A total of 50 consecutive patients (86% male; median age, 82 years) underwent endovascular repair of abdominal aortic aneurysms (AAAs) ranging from 4.0 to 9.0 cm (median, 5.2 cm). Efficacy of aneurysm exclusion was assessed by angiography, duplex scan, and/or contrast-enhanced computed tomography (CT). Acute technical success was 82%. Access failed in one patient, and immediate conversion to open operation was required in two patients. Improper deployment of the endoluminal graft (ELG) across the renal arteries occurred in one patient. The median operation time, estimated blood loss, packed red blood cells received, contrast volume, and length of intensive care and hospital stay were 128 min, 200 mL, 0.1 unit, 297 mL, 0.9 days, and 3 days, respectively. ELG limb thrombosis was seen in one patient. There were 4 (8%) early endoleaks, and 2 endoleaks were discovered in other patients at 3 and 6 months. Local/vascular and remote/systemic postoperative complications were seen in 13 (26%) and 9 (18%) patients, respectively. At a median follow-up of 11 months (range 2 to 36 months), clinical success was 78%. The aneurysm sac diameter (n = 49) decreased from a preoperative median of 5.2 to 4.7 cm (p = 0.0001). Technical success was high, and results at 11 months were satisfactory. Long-term outcomes require further study.
authors.affiliation: Department of Cardiovascular Surgery, Arizona Heart Institute and Foundation, Arizona Heart Hospital, 2632 North 20th Street, Phoenix, AZ 85006, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Lobato
authors.forename: J
authors.initials: J
authors.lastname: Rodriguez-Lopez
authors.forename: A
authors.initials: A
authors.lastname: Malik
authors.forename: M
authors.initials: M
authors.lastname: Vranic
authors.forename: P L
authors.initials: PL
authors.lastname: Vaughn
authors.forename: M
authors.initials: M
authors.lastname: Douglas
authors.forename: E B
authors.initials: EB
authors.lastname: Diethrich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over / Q000502:physiology*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures