20/02/2026
We recently looked at outcomes of Aortic Aneurysm Repair in Patients 85 years and over
Aim
The average life expectancy in the UK is 83 years for women and 79 for men. This audit investigated 1 year post-operative outcomes of patients who had elective repair of abdominal aortic aneurysms aged 85 years or older in a major UK vascular unit. The aim was to assess safety in the very elderly, benchmarking this against the UK National Vascular Registry data for all comers.
Methods
Retrospective audit at a major UK vascular unit. An independent researcher identified all abdominal aortic aneurysm repairsperformed between January 2024 and January 2025. The minimum follow up was 1 year. Hospital electronic records were used to determine ASA grade and the following outcomes:length of stay, post-operative complications, reintervention, amputation and death within the first year.
Results
Sixteen cases were identified, of which 16/16 (100%) were repaired with EVAR. Median age was 86 years (range 85-91) and median ASA grade was 3 (range 2-4). Median length of stay was 2 days (IQR 1-6) and in hospital mortality was 0/16 (0%). 3/16 (19%) had post-operative complications which were mild (Clavien-Dindo scale 1 or 2). These included pulmonary oedema, contrast induced nephropathy and fast atrial fibrillation. None required vascular reintervention in hospital.
Over the first post-operative year: 2/16 (13%) died – one from EVAR thrombosis following resection of colorectal tumour and one non-vascular death. 2/16 (13%) required unplanned vascular reintervention including one femoral ligation for infected pseudoaneurysm and one femoropopliteal bypass graft for CLTI. There were no amputations.
Conclusion
In comparison to all-comers undergoing EVAR in the UKNational Vascular Registry, this series of very elderly patients performed well, with no in-hospital deaths or serious complications and an identical length of stay. Similarly over the first post-operative year there were no aortic reinterventions and no amputations.
This series demonstrates that EVAR is as safe in 85y+ patients as it is in the wider population, when cases are selected appropriately. Therefore the benefit of EVAR in these patients is dependent on their longevity. This is now being examined by 5 year follow up in our unit.
