title: [Efficacy and safety analysis of endovascular aortic repair of abdominal aortic aneurysms in patients over eighty years old].
abstract: OBJECTIVE
  To evaluate the outcome of the endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAA) in patients over 80 years old and analyze the factors that influence its long-term curative effect.
  
  
  METHODS
  Follow-up visits and analysis were conducted from January 2004 to December 2013 on a total of 96 AAA patients aged over 80 years old who had been treated with EVAR and thus met the inclusion criteria. The primary focus of the study was all-cause mortality and secondary focuses included the rate of intervention-related complications, the rate of secondary interventions and procedural data. The Kaplan-Meier survival curve was used to analyze the long-term survival rate and the cumulative probability of intervention-related complications. The Cox proportional hazards regression model was used to analyze factors that could influence the long-term survival rate.
  
  
  RESULTS
  Effective follow-up visits were conducted on 76 patients (79.2%). The patients were tracked for an average of 3.63 years, with the longest follow-up lasting 10.34 years. During the study, 27 deaths occurred and the all-cause mortality rate was 28.1%. Furthermore, 8 cases of intervention-related complications (8.3%) were observed, including endoleaks and spinal cord ischemia. A total of 6 secondary interventions were conducted on 6 patients, with the rate of secondary interventions being 6.3%. The five-year cumulative survival rate was 64% (95%CI: 0.53-0.78) and the ten-year cumulative survival rate was 35%(95%CI: 0.15-0.84). The Cox proportional hazards model showed that an ASA classification of Ⅲ/Ⅳ (HR=8.45, 95%CI: 1.26-56.55, P<0.05), smoking (HR=2.08, 95%CI: 0.70-2.63, P<0.05) and cerebrovascular diseases (HR=2.96, 95%CI: 1.06-8.25, P<0.05) could significantly increase the risk of the long-term all-cause mortality of an AAA patient treated with EVAR. While hypertension could significantly decrease the risk (HR=0.25, 95%CI: 0.10-0.66, P<0.05).
  
  
  CONCLUSIONS
  EVAR is safe for senior patients with AAA though personalized preoperative assessment is very important.
authors.affiliation: Department of Vascular Interventional Surgery, Weihai Central Hospital, Weihai 264400, China.
authors.forename: Zhihao
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Vascular Surgery, People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.forename: Xin
authors.initials: X
authors.lastname: Jia
authors.forename: Senhao
authors.initials: S
authors.lastname: Jia
authors.forename: Minhong
authors.initials: M
authors.lastname: Zhang
authors.forename: Guoyi
authors.initials: G
authors.lastname: Sun
authors.forename: Yan
authors.initials: Y
authors.lastname: Feng
authors.forename: Nannan
authors.initials: N
authors.lastname: Pei
authors.forename: Jia
authors.initials: J
authors.lastname: Zhang
authors.forename: Chen
authors.initials: C
authors.lastname: Duan
authors.forename: Zhongyin
authors.initials: Z
authors.lastname: Wu
authors.forename: Hongpeng
authors.initials: H
authors.lastname: Zhang
authors.forename: Jiang
authors.initials: J
authors.lastname: Xiong
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Ma
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
mesh_terms: D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal; D057867:Endoleak; D057510:Endovascular Procedures; D006801:Humans; D053208:Kaplan-Meier Estimate; D016016:Proportional Hazards Models; D019651:Plastic Surgery Procedures; D015996:Survival Rate