Treatment for Abdominal Aortic Aneurysm in Patients Older than 85 Years-old

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Objective: To investigate the short-term and long-term results of surgical treatment for Abdominal Aortic Aneurysm (AAA) in patients older than 85 years old.Methodology: A retrospective study was conducted involving 106 patients older than 85 years old who underwent surgical treatment through graft replacement (GR) or endovascular aneurysm repair (EVAR) for AAA between 1989 and 2010. For the 13 patients with ruptured AAA, GR was indicated. As for the 93 patients with non-ruptured AAA, GR was indicated in 67 while EVAR was indicated in 26. The life expectancy was 5.37 (2.96–7.97) years at the time of surgery.Results: The hospital mortality for ruptured AAA cases was 30.8%. In non-ruptured cases, the hospital mortality after GR was 6.0% and after EVAR was 0% which were remarkably low. The overall survival rate was 74.2% at 3 years and 46.0% at 5 years. Comparing GR and EVAR in non-ruptured cases, survival rate at 3 years (78.1%/71.1%) and at 5 years (50.0%/71.1%) showed no significant difference (p=0.544). Among 54 patients with non-ruptured AAA whose life expectancy has passed, 25 had died before the period of life expectancy and 29 (53.7%) had lived for life expectancy.Conclusions: Our surgical strategy for AAA in patients over 85 years old could be justified in the aspect of life expectancy.