Treatment of aneurysms of abdominal aorta in older patients

Background

The treating aortic aneurysms in older persons, specially those older around 80, has undergone a significant modify with the launch regarding aortic stent (EVAR). However some scientific tests are in progress regarding the improvement associated with long lasting results with regard to Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½ surgery, it is evident that the particular exemption of the aneurysm with a stent is more suitable in terms of the fast sufferer administration, morbidity and mortality. In our institution we have obtained a significant embrace treating people with aortic aneurysm treated with Endovascular aortic repair. We present data for the last two years 2009 and 2010.

Materials as well as methods

In Cleveland Centre, from January 2009 to November 2010, 168 aneurysms of the thoracic and abdominal aorta were treated, of which 135 were elective and 33 emergency. Of these 39 % were patients over 75 years of age. In 2009 we operated 52 patients of whom 7 (13:45%) for thoracic aortic aneurysm and 45 (86.55%) for aneurysms of the abdominal aorta. 6 thoracic aneurysms (86%) were operated on electively and 1 (14%) urgently, all with a stent implant. 40 aneurysms of the abdominal aorta (89%) were operated on electively (of these 25 (62.5%) with EVAR and 15 (37.5%) with Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½ surgery) and 5 (11% ) in emergency (all in Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½). In 2010, 116 patients were treated, of which 20 (17.3%) had an aneurysm of the thoracic aorta and 96 (83.4) an aneurysm of the abdominal aorta. 14 aneurysms of the thoracic aorta (70%) were operated on electively and 6 in emergency (30%), all with EVAR. 80 aneurysms of the abdominal aorta (83.3%) were operated on electively (of these 70 (87.5%) with EVAR and 10 (12.5%) treated with Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½ surgery) and 16 (16.6%) in urgency (two of these (12.5%) with EVAR and 14 (87.5%) treated with Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½ surgery).

Results

The fatality rate in elective patients was 0.7% (1 patient underwent an endograft for abdominal aorta), while in emergency mortality was 18% (6 patients all operated in Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½). In one patient who undergo aorÃÂ­tic stent there was an acute renal failure with long lasting dialysis. Cardiological issues were resolved ahead of discharge.

Conclusions

The treating of aneurysms of the thoracic along with abdomÃÂ­inal aorta has got upgraded in terms of death rate and morbidity after the release of EVAR. In our working experience, which tends to broaden the effective use of aortic endoprosthesis, there are zero substantive differences in outcome among EVAR and Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½ surgery. Older sufferers sustain much better treatment method having an aortic stent graft.