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Home > Vascular Annual Meeting > PVSS10. Long-Term Outcomes of EVAR in Octogenarians

PVSS10. Long-Term Outcomes of EVAR in Octogenarians

Rodrigo B. Fonseca, MD; Caron B. Rockman, MD; Abhishek Pitti, MD; Neal Cayne, MD; Tom S. Maldonado, MD; Glenn R. Jacobowitz, MD; Thomas Riles, MD; Patrick J. Lamparello, MD; Mark A. Adelman, MD
New York University Vascular Surgery, West Orange, NJ; NYU Medical Center; New York, NY

OBJECTIVES: The utilization of endovascular abdominal aortic aneurysm repair (EVAR) in suitable patients has resulted in decreased perioperative morbidity and mortality. Octogenarians as a subgroup have been more readily offered EVAR as it is less invasive, and therefore presumably better tolerated. The purpose of this study is to investigate periprocedural and late EVAR outcomes in octogenarians as compared with patients less than 80 years of age.

METHODS: From January 2003 to May 2008, 322 patients underwent EVAR. A total of 117 octogenarians were compared to 205 patients less than 80 years of age. A retrospective review of the demographic data, aneurysm details, perioperative morbidity, mortality and late outcomes were analyzed.

RESULTS: There were no significant differences in the rates of perioperative myocardial infarction, stroke, death, intestinal, or arterial ischemic complications between the two groups. Octogenarians had a significant higher rate of pulmonary complications (5.1% vs. 1%, p<.03) and access-site hematomas (12% vs. 2.4%, p=.001) than younger patients. When all significant perioperative morbidity was combined, octogenarians were twice as likely to develop complications following EVAR than younger patients (27.4% vs. 11.7%, p=.001). The overall endoleak rates were similar in both groups (17.5% vs. 12.6%, p=ns).

CONCLUSIONS: EVAR can be performed safely and effectively in octogenarians, and the incidence of major complications including MI, stroke, and death is unchanged compared to younger patients. However, there is a significantly increased rate of some types of perioperative complications in octogenarians, as well as perioperative complications as a whole. Our findings suggest EVAR remains a suitable form of therapy in the elderly group provided there is an appropriate preoperative evaluation and perioperative monitoring following repair.

AUTHOR DISCLOSURES: R.B. Fonseca, None; C.B. Rockman, None; A. Pitti, None; N. Cayne, None; T.S. Maldonado, None; G.R. Jacobowitz, None; T. Riles, None; P.J. Lamparello, None; M.A. Adelman, None.