Endovascular Aortic Repair in Patients of Advanced Age
| Autor: | Jacqueline Babb, J. Gregory Modrall, Bala Ramanan, Christopher A. Heid, Carlos H. Timaran, Mitri K. Khoury, Micah Thornton, Melissa L. Kirkwood, Shirling Tsai |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Aortic repair Endovascular aneurysm repair Risk Assessment Blood Vessel Prosthesis Implantation Aneurysm Risk Factors medicine Humans Radiology Nuclear Medicine and imaging In patient Aged Retrospective Studies Aged 80 and over business.industry Endovascular Procedures medicine.disease Abdominal aortic aneurysm Surgery Aortic Aneurysm Treatment Outcome Female Treatment decision making Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal |
| Zdroj: | Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists. 29(3) |
| ISSN: | 1545-1550 |
| Popis: | Purpose: Treatment decisions for the elderly with abdominal aortic aneurysms (AAAs) are challenging. With advancing age, the risk of endovascular aneurysm repair (EVAR) increases while life expectancy decreases, which may nullify the benefit of EVAR. The purpose of this study was to quantify the impact of EVAR on 1-year mortality in patients of advanced age. Materials and Methods: The 2003–2020 Vascular Quality Initiative Database was utilized to identify patients who underwent EVAR for AAAs. Patients were included if they were 80 years of age or older. Exclusions included non-elective surgery or missing aortic diameter data. Predicted 1-year mortality of untreated AAAs was calculated based on a validated comorbidity score that predicts 1-year mortality (Gagne Index, excluding the component associated with AAAs) plus the 1-year aneurysm-related mortality without repair. The primary outcome for the study was 1-year mortality. Results: A total of 11 829 patients met study criteria. The median age was 84 years [81, 86] with 9014 (76.2%) being male. Maximal AAA diameters were apportioned as follows: 39.6% were Conclusion: The current data suggest that EVAR decreases 1-year mortality rates for patients of advanced age compared to non-operative management in the elderly. However, the survival benefit is largely limited to those with Gagne Indices 0–1 with AAAs ≥ 5.5 cm and Gagne Indices 2–5 with AAAs ≥ 7.0 cm. Those of advanced age may benefit from EVAR, but realizing this benefit requires careful patient selection. |
| Databáze: | OpenAIRE |
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