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

Jun Gyo Gwon; Seonjeong Jeong; Hana Jin; Gi-Young Ko; Yong-Pil Cho; Tae-Won Kwon

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자료유형: 학술저널

저자정보: Jun Gyo Gwon (University of Ulsan College of Medicine) Seonjeong Jeong (University of Ulsan College of Medicine) Hana Jin (University of Ulsan College of Medicine) Gi-Young Ko (University of Ulsan College of Medicine) Yong-Pil Cho (University of Ulsan College of Medicine) Tae-Won Kwon (University of Ulsan College of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.103 No.6

발행연도: 2022.12

수록면: 372 - 377 (6page)

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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.

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

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