Outcomes of Endovascular Aneurysm Repair in Octogenarians and Nonagenarians: A Single-Center Study

Objectives: Endovascular aneurysm repair (EVAR) has enabled the treatment of aneurysmal disease in those of significantly advanced age. Although there have been positive experiences documented in the literature, the feasibility of EVAR in octogenarians and nonagenarians as a demographic are still largely unknown. We report a single-center experience with EVAR in octogenarians and nonagenarians. Methods: Cases of EVAR in octogenarians and nonagenarians were identified retrospectively at our center over 5 years using a prospectively maintained database. Results: Seventeen patients undergoing EVAR at our institution were reviewed; this included 14 octogenarians and 3 nonagenarians. Of these, 94% were male, with a mean age of 86.6 (81–98) years and a mean aneurysm diameter of 7.6 cm. The average number of comorbidities in our cohort was 2.6. Perioperative morbidity was 35.3% and consisted of hospital-acquired pneumonia, ischemic bowel, and one return to theater for bleeding from the access site. 30-day mortality was 17.6% (n = 3), with 2 of these patients undergoing repair for a ruptured AAA. Mean survival in those surviving 30 days was 27.8 months (39 days–51 months). Conclusion: EVAR in octogenarians and nonagenarians is feasible with good technical outcomes and acceptable perioperative morbidity and mortality.

Publication History

Article published online:
26 April 2021