Procedural and long-term outcomes of elective endovascular abdominal aortic aneurysm repair in octogenarians

Fernando Garagoli, Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Juan G. Chiabrando, Interventional Cardiology Unit; Department of Digital Angiography. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
José G. Chas, Department of Digital Angiography. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Martín Rabellino, Department of Digital Angiography. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Ignacio M. Bluro, Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires;; Servicio de Cardiología, Hospital Italiano de Buenos Aires

Abstract
Objective: The aim of the study was to compare the immediate and long-term outcomes of endovascular aneurysm repair (EVAR) between patients under and over the age of 80 with abdominal aortic aneurysm (AAA). Methods: From 2011 to 2017, we conducted a retrospective cohort study with AAA patients who received elective EVAR. Primary outcomes included hospital mortality, length of stay, acute kidney injury, and the need for re-interventions. Secondary outcomes included aneurysm-related mortality, acute myocardial infarction, stroke, acute limb ischemia, and prolonged mechanical ventilation. Results: A total of 77 (62.6%) patients under the age of 80 years old and 46 (37.4%) octogenarians were included in the study. The male gender and AAA diameter did not differ among groups (92.2% vs. 82.6%, p = 0.11 and 5.4 cm [4.9-6.2 cm] vs. 5.4 cm [5-6 cm], p = 0.53, respectively). The younger patients had a higher prevalence of tobacco use (72.7% vs. 41.7%, p = 0.01). There were no deaths during the index hospitalization. The incidence of reinterventions (5.3% vs. 15.2%, p = 0.11) and acute kidney injury (14.3% vs. 23.9%, p = 0.18) did not differ between groups, but the length of stay was longer for octogenarian patients (3 days [2-4] vs. 2 days [2–3, p = 0.04)]. Endoleaks were the most common cause for re-interventions (81.8%), with a prevalence of 34% across the entire cohort. There were no differences in any of the secondary outcomes between groups. Conclusion: In octogenarian patients with AAA, EVAR represents a safe procedure both during the index hospitalization and during long-term follow-up.

Palabras clave: Abdominal aortic aneurysm. Endovascular aneurysm repair. Octogenarians.