title: Endovascular repair of the thoracic aorta in octogenarians.
abstract: BACKGROUND
  To evaluate the feasibility and safety of thoracic endografting in the octogenarian population.
  
  
  METHODS
  Between February 2000 and August 2005, 249 patients with a mean age of 69+/-12.3 years (range 23-91) underwent thoracic endografting. Forty-four patients (27 males and 17 females) were octogenarians with a mean age of 84+/-2.7 years. Indications for intervention included: atherosclerotic aneurysms (26/44, 59%), acute and chronic dissections (9/44, 20.5%), penetrating aortic ulcers (6/44, 14%) and contained rupture (3/44, 7%).
  
  
  RESULTS
  Endovascular repair was achieved in all octogenarian patients (44/44, 100%). Mean length of stay was 4.7+/-3.6 days. Two cardiac-related deaths and 1 retrograde dissection death occurred (3/44, 7%). Complications included hemiparesis (n=2) with full recovery at discharge, groin hematoma (n=1), pneumonia (n=2) and stroke (n=1) [6/44, 11%]. Endoleaks were diagnosed in 3 patients [3/44, 7%] (2 type I, 1 type II) at 30-day follow-up. Two patients developed an endoleak beyond 30 days [2/44, 5%] (1 type I, 1 type II). Two re-interventions were necessary at 30 days (1 type I, 1 type II). Mean follow-up was 22 months and there were no device migrations or aortic ruptures. No statistical differences in overall mortality were noted between octogenarians and non-octogenarians at 30 days (7% vs 6%, p=NS), 12 months (18% vs 13%, p=NS) and 24 months (27% vs 15%, p=NS). However, at 5 years post-procedure, octogenarians had a significantly higher overall mortality than non-octogenarians (32% vs 17%, p=0.038).
  
  
  CONCLUSIONS
  Advanced age is not a contraindication to thoracic endografting with favorable short and mid-term outcomes compared to non-octogenarians.
authors.affiliation: Arizona Heart Institute, Department of Cardiovascular and Endovascular Surgery, Phoenix, AZ, USA. jkpodonu@yahoo.com
authors.forename: Jacques
authors.initials: J
authors.lastname: Kpodonu
authors.forename: Ourania
authors.initials: O
authors.lastname: Preventza
authors.forename: Venkatesh G
authors.initials: VG
authors.lastname: Ramaiah
authors.forename: Hani
authors.initials: H
authors.lastname: Shennib
authors.forename: Grayson H
authors.initials: GH
authors.lastname: Wheatley
authors.forename: Julio A
authors.initials: JA
authors.lastname: Rodriquez-Lopez
authors.forename: James
authors.initials: J
authors.lastname: Williams
authors.forename: Edward B
authors.initials: EB
authors.lastname: Diethrich
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult