Experience with endovascular abdominal aortic aneurysm repair in nonagenarians.
OBJECTIVE
To report a single-institution experience with endovascular abdominal aortic aneurysm (AAA) repair (EVAR) in nonagenarians.


METHODS
A retrospective review was performed of all patients >90 years old undergoing EVAR over an 8-year period at a major academic medical center. The patient population was investigated for the presence of various comorbidities, initial aneurysm size, successful aneurysm exclusion, perioperative complications, disposition, endoleaks, secondary interventions, and overall survival.


RESULTS
EVAR was performed in 18 male nonagenarians (mean age 92.4 years, range 90- 95). Mean aneurysm diameter was 7.3 cm (range 5.5-9.8). The cohort had an average of 3.2 comorbid conditions. Sixteen patients were treated electively, while 2 patients underwent emergent repair for contained rupture and bleeding aortoenteric fistula, respectively. Immediate technical success was 100%. Perioperative local/vascular complications occurred in 4 (22%) patients. Perioperative systemic complications occurred in 3 (17%) patients. There were 2 (11%) perioperative (<30 days) deaths. Three (17%) patients required secondary interventions. Mean survival in patients who expired during the follow-up period beyond the first 30 days was 34 months (range 8-78). Mean survival in 8 patients who are still alive is 17.4 months (range 9-39).


CONCLUSIONS
Endovascular AAA repair in nonagenarians is associated with a high rate of technical success and relatively low morbidity rate. Survival times following successful hospital discharge are significant. Suitable patients over 90 years of age may benefit from an endovascular AAA repair.
Baril
Donald T
DT
Division of Vascular Surgery, Department of Surgery, Mount Sinai School of Medicine, New York, New York, USA. Donald.Baril@mssm.edu
Palchik
Eugene
E
Carroccio
Alfio
A
Olin
Jeffrey W
JW
Ellozy
Sharif H
SH
Jacobs
Tikva S
TS
Ponzio
Marc M
MM
Teodorescu
Victoria J
VJ
Marin
Michael L
ML
D000367:Age Factors; D000369:Aged, 80 and over; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed