Endovascular Aortic Aneurysm Is Feasible in Select Elderly Patients: Presented at ISET

By Ed Susman

HOLLYWOOD, Fla -- January 28, 2019 -- Patients in their 80s and 90s appear to be able to tolerate repair of abdominal aortic aneurysms using endovascular devices, according to a study presented here at the 2019 Annual International Symposium on Endovascular Therapy (ISET).

Technical success in placing the endovascular stent was achieved in 127 of 128 patients in the study, according to Ahmad Abu Rmeileh, MD, Chaim Sheba Medical Center, Tel HaShomer, Israel, and colleagues.

According to the authors, endovascular aortic repair (EVAR) can be performed with a high rate of success.

In the case series presented (2007-2017), about 38% of the patients survived 5 years.

Once the EVAR device was implanted, more than 80% of the patients did not require re-intervention. The mean diameter of the aneurysm was 61 mm (range, 37-105 mm).

When compared with a younger population, the risk of mortality and morbidity was greater in the older population, as expected.

The mean age of the patients in the study was 84 years and there were 11 patients who were in their 90s that were treated with the devices.

Nine patients succumbed in the perioperative period (30 days), including 3 of the nonagenarians. Causes of death included respiratory complications (n = 3), gastrointestinal complications (n = 2), bleeding (n = 1), cardiac event (n = 1), distant emboli (n = 1), and sepsis (n = 1).

The researchers determined that patients at greatest risk for mortality or a major adverse event were those who had chronic kidney disease, peripheral artery disease or ≥3 comorbidities.

Minor adverse events were observed in 46% of the patients who underwent the procedure.

Dr. Rmeileh suggested that clinicians carefully weigh the risks and benefits of elderly patients undergoing endovascular aneurysm repair by assessing various factors, especially comorbidities and life expectancy.

[Presentation title: Morbidity and Mortality Following Endovascular Aneurysm Repair of Abdominal Aortic Aneurysms Among Octogenarians and Nonagenarians. Abstract 36]

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