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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2001 December;20(4):351-3

language: English

Successful surgical repair of a ruptured abdominal aortic aneurysm in a nonagenarian

Lorenzi M., Coratti A., Tani F.

From the Insti­tute of Gen­er­al Sur­gery and Sur­gi­cal Spe­cial­ities, Uni­ver­sity of Siena, Siena, Italy


Mor­tal­ity due to the sur­gi­cal treat­ment of rup­tured abdom­i­nal aor­tic aneu­rysms (RAAA) is high, more than 40%, espe­cial­ly in eld­er­ly ­patients. The lit­er­a­ture con­cern­ing RAAA in very eld­er­ly ­patients is ana­lyzed by Inter­net ­research (Med­line). Only rare exam­ples of emer­gen­cy sur­gi­cal man­age­ment in non­age­nar­ian ­patients are report­ed, and even fewer ­reports of suc­cess­ful­ly oper­at­ed ­patients. A case ­report of a suc­cess­ful sur­gi­cal ­repair of RAAA in a non­age­nar­ian is pre­sent­ed. After ultra­sound (US) and CT scans, the ­patient (in good con­di­tion as ­regards blood pres­sure, res­pir­a­to­ry, car­diac and renal func­tion) under­went unevent­ful aneu­rys­mec­to­my and recon­struc­tion of the aorta and com­mon iliac arter­ies by means of a bifur­cat­ed pros­the­sis. The ­length of hos­pi­tal­iza­tion was 30 days and the ­patient is still alive and in good con­di­tion four years and two ­months after the oper­a­tion. The advis­abil­ity of emer­gen­cy sur­gi­cal ­repair in these ­patients, ques­tion­able ­because of the exces­sive sur­gi­cal risk and poor sur­vi­val ben­e­fit, is dis­cussed. How­ev­er many other fac­tors ­affect the out­come of emer­gen­cy ­repair (main­ly car­diac, res­pir­a­to­ry and renal func­tion), indi­pen­dent­ly of age. The ­authors con­clude that age per se does not limit the indi­ca­tion for or suc­cess of sur­gery in very eld­er­ly ­patients.

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