P182. Investigation of Risk Factors and Outcomes of Aortic Arch Aneurysm Repair in Octogenarians
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Yokohama city university medical center
Yokohama, Kanagawa
Japan - Contact Me
Tomoki Cho was born in Kanagawa, Japan, in 1978. He received a Ph.D. in the field of acute type A aortic dissection from Yokohama city university, Japan, in 2021. He is an assistant professor of Yokohama city university medical center. His work focuses specifically on the endovascular treatment of aortic dissection and aortic aneurysm.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
[Objective] Total arch replacement is the first-choice treatment for aortic arch aneurysms; however, total arch replacement is a high-risk procedure, and endovascular repair may be the treatment of choice in elderly patients. We investigated the risk factors associated with each technique and treatment outcomes of aortic arch aneurysm repair in elderly patients (age >80 years).
[Methods] The study included 54 octogenarians who underwent aortic arch aneurysm repair between 2007 and 2021. Patients were categorized into the total arch replacement (TAR) group (23 patients) and the thoracic endovascular aortic repair (TEVAR) group (31 patients). Early and mid-term outcomes and risk factors associated with mortality were investigated in each group. TAR was the preferred therapy; however, TEVAR was performed in patients who were unable to tolerate TAR owing to frailty and comorbidities. True aneurysms were included and dissected aneurysms and emergency cases secondary to aneurysm rupture or other causes were excluded from the analysis to ensure evaluation of timely surgical outcomes.
[Results] Patients' mean age was 82 years in both groups (TAR [81-84 years], TEVAR [81-83 years]), without a significant intergroup difference. The incidence of stroke and spinal cord ischemia, the 30-day mortality (TAR [0.0%], TEVAR [5.4%]), and in-hospital mortality (TAR [7.7%], TEVAR [8.1%]) did not show significant intergroup differences. The 5-year survival rates (TAR [82.0%], TEVAR [65.0%], p=0.24), aorta-related mortality averted (TAR [91.0%], TEVAR [81.0%], p=0.13), and the freedom from aortic events (p=0.05) did not show significant intergroup differences. On analysis of risk factors for all-cause mortality for each procedure, a history of ischemic heart disease was identified as a significant risk factor in the TAR group. No significant risk factors were identified in the TEVAR group in this study.
[Conclusions] The choice of procedure in this study was reasonable considering patients' frailty. Endovascular repair is a good option for patients with a history of ischemic heart disease.
Authors
Tomoki Cho (1), Keiji Uchida (2), Shota Yasuda (3), Tomoyuki Minami (4), aya saito (3)
Institutions
(1) Yokohama city university medical center, Yokohama, Kanagawa, (2) Yokohama City University Medical Center, Yokohama, Kanagawa, (3) N/A, N/A, (4) N/A, Yokohama, Japan
[Methods] The study included 54 octogenarians who underwent aortic arch aneurysm repair between 2007 and 2021. Patients were categorized into the total arch replacement (TAR) group (23 patients) and the thoracic endovascular aortic repair (TEVAR) group (31 patients). Early and mid-term outcomes and risk factors associated with mortality were investigated in each group. TAR was the preferred therapy; however, TEVAR was performed in patients who were unable to tolerate TAR owing to frailty and comorbidities. True aneurysms were included and dissected aneurysms and emergency cases secondary to aneurysm rupture or other causes were excluded from the analysis to ensure evaluation of timely surgical outcomes.
[Results] Patients' mean age was 82 years in both groups (TAR [81-84 years], TEVAR [81-83 years]), without a significant intergroup difference. The incidence of stroke and spinal cord ischemia, the 30-day mortality (TAR [0.0%], TEVAR [5.4%]), and in-hospital mortality (TAR [7.7%], TEVAR [8.1%]) did not show significant intergroup differences. The 5-year survival rates (TAR [82.0%], TEVAR [65.0%], p=0.24), aorta-related mortality averted (TAR [91.0%], TEVAR [81.0%], p=0.13), and the freedom from aortic events (p=0.05) did not show significant intergroup differences. On analysis of risk factors for all-cause mortality for each procedure, a history of ischemic heart disease was identified as a significant risk factor in the TAR group. No significant risk factors were identified in the TEVAR group in this study.
[Conclusions] The choice of procedure in this study was reasonable considering patients' frailty. Endovascular repair is a good option for patients with a history of ischemic heart disease.
Authors
Tomoki Cho (1), Keiji Uchida (2), Shota Yasuda (3), Tomoyuki Minami (4), aya saito (3)
Institutions
(1) Yokohama city university medical center, Yokohama, Kanagawa, (2) Yokohama City University Medical Center, Yokohama, Kanagawa, (3) N/A, N/A, (4) N/A, Yokohama, Japan
Presentation Duration
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