Lentz, C. (Charlotte) (2021) Short-term outcomes after juxtarenal abdominal aneurysm repair in octogenarians. thesis, Medicine.
Full text available on request.Abstract
Background: Juxtarenal abdominal aortic aneurysms (JRAAA) are located proximally to the renal arteries but do not involve them.1 JRAAAs are associated with significant morbidity and mortality. Repair is via open surgical repair (OSR) or complex endovascular repair (EVAR). Knowledge regarding short-term outcomes following JRAAA repair in the elderly population is currently lacking. The aim of this study was to evaluate short-term outcomes after JRAAA repair in octogenarians. Methods: Patients having received elective, primary surgical JRAAA repair from 2016 until 2018 registered in the Dutch Surgical Aneurysm Audit (DSAA) were included. Descriptive statistics were used to compare preoperative, intraoperative, and postoperative outcomes between non-octogenarians and octogenarians. Patients having received OSR and EVAR were evaluated separately. Logistic regression was used to calculate adjusted odds ratios for outcomes. Results: 596 patients received JRAAA repair in the Netherlands between 2016-2018; 376 (63.1%) underwent OSR and 220 (36.9%) underwent FEVAR, 83 (13.9%) patients were octogenarians. Following OSR of JRAAAs, octogenarians suffered from significantly more complications (61.1% vs 43.8%), major complications (38.9% vs 22.9%), higher 30-day mortality rates (16.7% vs 4.1%) and higher failure to rescue rates (16.7% vs 4.1%) compared to non-octogenarians. No significant differences were found in outcomes following FEVAR of JRAAAs between non-octogenarians and octogenarians. Within the octogenarian cohort, patients having received OSR suffered from significantly higher complication rates (61.1% vs 38.3%) and IC-admission rates (88.9% vs 51.1%) than those having received FEVAR. Conclusion: Endovascular repair should be the preferred choice of treatment of JRAAAs in octogenarians. Carrying out open surgical repair of JRAAAs in octogenarians is associated with high complication rates and short-term mortality.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Laan, Dr. van der |
| Faculty: | Medical Sciences |
| Date Deposited: | 05 Jan 2022 10:57 |
| Last Modified: | 05 Jan 2022 10:57 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2940 |
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