Ann Surg Treat Res.  2022 Dec;103(6):372-377. 10.4174/astr.2022.103.6.372.

Similar long-term outcomes between endovascular aneurysm repair and open surgical repair for abdominal aortic aneurysms in octogenarian patients: a single-center study

• Gwon JG
• Jeong S
• Jin H
• Ko GY
• Cho YP
• Kwon TW

• KMID: 2536913
• DOI: http://doi.org/10.4174/astr.2022.103.6.372

Abstract

Purpose
Endovascular aneurysm repair (EVAR) has lower perioperative mortality and morbidity rates and shorter hospital stays when compared to open surgical repair (OSR) in octogenarian patients. However, its long-term results remain unclear. Hence, we aimed to analyze and compare the long-term outcomes of OSR and EVAR in this aging population.
Methods
This single-center, retrospective, observational study analyzed the data of patients older than 80 years who underwent primary repair of an abdominal aortic aneurysm (AAA) between 2011 and 2016 in our hospital. The primary outcomes were in-hospital complications and 30-day mortality, while the secondary outcomes included all-cause mortality and reintervention rate.
Results
Among the 48 patients with elective AAA repair, 13 underwent OSR and 35 underwent EVAR. In-hospital complications occurred in 10 patients (20.8%), 5 for OSR (38.5%) and 5 for EVAR (14.3%) with no significant difference between the groups (P = 0.067). In the OSR group, pulmonary complications were the most common events; in the EVAR group, 2 patients had ischemic colitis diagnosed with sigmoidoscopy and recovered by conservative treatment. The 1- and 5-year survival rates were 77.8% and 55.6% in the OSR group, and 66.0% and 54.9% in the EVAR group, respectively. The reintervention rate was 8.6% for the EVAR group; none of the OSR group were readmitted.
Conclusion
The difference in procedures did not affect patient survival. Therefore, OSR does not necessarily have a worse prognosis than EVAR. Individual risk stratification must be preceded before the selection of an appropriate treatment method.

Keyword

Abdominal aortic aneurysm; Endovascular procedures; Hospital mortality; Octogenarians; Postoperative complications

Figure

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  Fig. 1 A cumulative Kaplan-Meier graph of the overall survival of patients who underwent abdominal aortic aneurysm repair based on the open surgical repair (OSR) or endovascular aneurysm repair (EVAR) procedure methods.

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