Treatment of aneurysms of abdominal aorta in aged patients

Background

The treatment of abdominal aortic aneurysms in older affected individuals, especially those aged close to 80, has undergone a significant transformation with the launch regarding aortic stent (EVAR). However some scientific studies are in development regarding the advance associated with long lasting results with regard to Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½ surgical treatments, it is evident that the particular exemption of the aneurysm with a stent is much more appropriate in terms of the instant patient management, morbidity and death rate. In our establishment we have obtained an enormous embrace treating people with aortic aneurysm treated with Endovascular abdominal aortic aneurysm repair. We present data for the last two years 2009 and 2010.

Supplies as well as solutions

In Cleveland Medical 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 aortic 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 death rate in elective patients was 0.7% (1 patient underwent an endograft for abdominal aorta), while in emergency fatality was 18% (6 patients all operated in Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½). In one patient who underwent aorÃÂ­tic stent there was an acute renal failure with long term dialysis. Cardiological issues were solved before discharge.

Conclusions

The treatment 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 experience, which tends to increase the usage of aortic endoprosthesis, there are simply no significant differences in outcome among EVAR and Ã¢ï¿½ï¿½openÃ¢ï¿½ï¿½ surgery. Elderly affected individuals sustain better therapy with the aortic stent graft.