title: Outcomes of total endovascular treatment of juxtarenal aortic aneurysms in octogenarians.
abstract: OBJECTIVE
  We set out to present the late 3-year performance of total endovascular treatment of juxtarenal aortic aneurysms in octogenarians by the chimney/snorkel technique.
  
  
  METHODS
  At one center, between January 2009 and December 2014, chimney/snorkel technique-endovascular aortic aneurysm repair was performed in 35 high-risk unfit-for-open-repair octogenarian patients with juxtarenal aortic aneurysms. Twenty-five patients were asymptomatic (71.4%), and 10 patients were treated in an urgent care setting. The median follow-up was 36 months (range, 1-69). The primary endpoint was the survival rate.
  
  
  RESULTS
  Technical success was 100%. A single chimney-graft placement was performed in 22 patients (62.9%), double chimneys in 10 patients (28.6%), and triple chimneys were performed in 3 (8.5%) patients. Overall, 51 renovisceral vessels (22 right renal arteries, 23 left renal arteries, and 6 superior mesenteric arteries) were involved. The thirty-day mortality rate was 2.9% (n = 1). Early morbidity was 14.3%, predominantly due to access-related complications. Major adverse events were observed in 5.7% (n = 2) of the present cohort. No early reinterventions for endoleaks were registered. The midterm reintervention rate was 12.1% due to type Ib endoleak (n = 1), type II endoleak (n = 1), and high-grade chimney-graft stenosis (n = 2). Estimated survival was 91.9% at 1 year and 72.8% at 3 years. Freedom from reintervention at 1 and 3 years was 94% and 91%, respectively.
  
  
  CONCLUSIONS
  Juxtarenal aortic aneurysm treatment with chimney/snorkel technique-endovascular aortic aneurysm repair in octogenarians is associated with low perioperative mortality and morbidity as well as acceptable midterm survival and secondary procedures.
authors.affiliation: Department of Angiology and Vascular Surgery, Hospital St. António, Centro Hospitalar do Porto, Porto, Portugal. Electronic address: diogo.slvr@gmail.com.
authors.forename: Diogo
authors.initials: D
authors.lastname: Silveira
authors.affiliation: Division of Vascular Surgery, Aristotle University Thessaloniki, Thessaloniki, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Pitoulias
authors.affiliation: Clinic of Vascular and Endovascular Surgery, University of Münster and Department of Vascular Surgery, St. Franziskus Hospital, Münster, Germany.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Torsello
authors.affiliation: Clinic of Vascular and Endovascular Surgery, University of Münster and Department of Vascular Surgery, St. Franziskus Hospital, Münster, Germany.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Donas
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D018572:Disease-Free Survival; D057867:Endoleak / Q000209:etiology / Q000628:therapy; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011474:Prosthesis Design; D019233:Retreatment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome