ORIGINAL ARTICLE  VASCULAR SECTION 

The Journal of Cardiovascular Surgery 2017 August;58(4):557-64

DOI: 10.23736/S0021-9509.16.08201-X

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Abdominal aortic aneurysm treatment: minimally invasive fast-track surgery and endovascular technique in octogenarians

Massimiliano MARTELLI ¹, Alessandra RENGHI ², Luca GRAMAGLIA ², Francesco CASELLA ¹, Piero BRUSTIA ¹ ✉

¹ Division of Vascular Surgery, Department of Surgery, Ospedale Maggiore della Carità, Novara, Italy; ² Department of Anesthesiology, Ospedale Maggiore della Carità, Novara, Italy

BACKGROUND: We conducted a retrospective study on patients aged over eighty who underwent elective surgery for an abdominal aortic aneurysm between January 2006 and December 2010. We compared our results with fast-track abdominal aortic surgery (OPEN group) and with endovascular aneurysm repair (EVAR group).
METHODS: We followed 97 consecutive octogenarians affected by abdominal aortic aneurysm who underwent elective surgery. A total of 55 patients were enrolled in the OPEN group (56.7%) and 42 were enrolled in the EVAR group (43.3%).
RESULTS: Eight patients (14.5%) in the OPEN group and six patients in the EVAR group (14.2%) received transfusions. None of the patients required admission to the intensive care unit. In total, 53 patients (98%) in the OPEN group and 34 patients (80%) in the EVAR group were able to get up and walk in the afternoon after the end of surgery. The recovery of intestinal transit was on day 2 in the OPEN group and on day 1 in the EVAR group. Patients in both groups were discharged on average on the fourth postoperative day. There were no perioperative mortalities in the OPEN and the EVAR groups.
CONCLUSIONS: Minimally invasive treatment with the fast-track protocol and EVAR are both valid options in octogenarian patients because we obtained comparable results in terms of resumption of feeding, early ambulation, days of hospitalization, perioperative rate of mortality and morbidity.

KEY WORDS: Abdominal aortic aneurysm - Minimally invasive surgical procedures - Angioplasty - Aged, 80 and over