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Ruptured abdominal aortic aneurysm in the elderly patient
R Chiesa1, C Setacci, Y Tshomba
1Department of Vascular Surgery, Vita-Salute University, Scientific Institute San Raffaele Hospital, Milan, Italy. chiesa.roberto@hsr.it
Acta Chirurgica Belgica
|December 16, 2006
Summary
Managing ruptured abdominal aortic aneurysms (rAAA) in elderly patients involves analyzing cost-effectiveness and repair indications. This study reviews risk factors, outcomes of open repair, and challenges of endovascular repair in this population.
Area of Science:
- Vascular Surgery
- Geriatric Medicine
- Health Economics
Background:
- Ruptured abdominal aortic aneurysm (rAAA) poses significant risks, especially in elderly patients.
- Treatment decisions for rAAA in older adults require careful consideration of risks, benefits, and cost-effectiveness.
- Both open surgical repair and endovascular repair present unique challenges in the geriatric population.
Purpose of the Study:
- To analyze the cost-effectiveness and indications for repairing rAAA in elderly patients.
- To review risk factors and outcomes associated with open repair of rAAA in the elderly.
- To discuss the challenges and feasibility of endovascular repair for rAAA in older individuals.
Main Methods:
- Literature survey on risk factors and outcomes of open rAAA repair in elderly patients.
- Discussion of challenges associated with endovascular repair of rAAA in the elderly.
- Retrospective analysis of personal experience with abdominal aortic aneurysm (AAA) repair in 163 patients aged 75 years and older (January 2003 - September 2005).
Main Results:
- The study included 163 patients aged 75+ undergoing AAA repair (89 endovascular stentgrafts, 74 open repairs).
- Of the total, 42 cases were rAAA, 23 were symptomatic AAA, and 98 were elective asymptomatic AAA.
- Data covers a period of significant evolution in endovascular techniques for AAA.
Conclusions:
- Management of rAAA in the elderly requires a tailored approach considering patient-specific factors.
- Both open and endovascular repair options have roles, with specific challenges in older patients.
- Further analysis of cost-effectiveness and long-term outcomes is crucial for optimizing rAAA treatment in the elderly.
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