20 - Freie Mitteilung
15. Mai 2019, 13:30 - 15:00, Sopra Grande, 4. OG
Early outcomes after branched and fenestrated endovascular aortic repair in octogenarians
V. Makaloski1, 2, T. Kölbel2, T. Wyss1, J. Schmidli1, Presenter: V. Makaloski1 (1Bern, 2Hamburg/DE)
To compare early outcome after complex endovascular aortic repair in octogenarians (age ≥80 years) versus non-octogenarians (age <80 years) treated with fenestrated or branched stent-grafts.
Single-center retrospective analysis from a prospectively collected database of all patients undergoing repair with fenestrated or branched stent-grafts for para/suprarenal aortic aneurysm, type Ia endoleak after previous endovascular aortic repair and thoraco-abdominal aortic aneurysm (TAAA) between January 2015 and December 2017. All patients were divided in two groups, non-octogenarians (age <80 years) and octogenarians (age ≥80 years) at the time of repair. Outcomes were the difference between the groups in all-cause mortality, major adverse events and need for re-intervention at 30-days. Preoperative and procedural variables were examined in a multiple logistic regression model as potentially associated factors with 30-day all-cause mortality.
207 patients [58 (28%) females] with median age of 73 years (IQR 68-78) underwent repair with fenestrated or branched stent-grafts. There were 169 (81%) non-octogenarians with a median age of 72 years (IQR 65-76) and 38 (19%) octogenarians with a median age of 82 years (IQR 81-84). Seventeen patients (five elective, twelve urgent procedures) died during 30-days (8%). Mortality rate was higher in the octogenarians [11 (7%) vs. 6 (16%), P=.09]. Two patients in each group had early stent-graft related re-interventions. Seven patients (one octogenarian) needed surgical revision of the common femoral artery and five patients (all non-octogenarians) of the right-sided brachial artery. Similar rates of postoperative sepsis, respiratory problems, renal function deterioration, spinal cord injury were found in both groups. After multiple logistic regression ASA class ≥ 4, TAAA and rupture were independent factors for 30-day all-cause mortality.
Complex endovascular repair in octogenarians has a trend to higher 30-day all-cause mortality compared with non-octogenarians without reaching significance. Age ≥80 year was not found to be an independent predictor for higher 30-day all-cause mortality.