Work

Influence of sex and advanced age on outcomes after endovascular aneurysm repair: a 13-year single-center retrospective cohort study

Year: 2026

Type: article

Abstract: Introduction Sex and advanced age may influence anatomical complexity and clinical outcomes after endovascular abdominal aortic aneurysm repair (EVAR). This study evaluated the impact of sex and age ≥ 80 years on peri-operative and long-term outcomes following EVAR. Methods We conducted a 13-year, single-center retrospective cohort study of 512 patients (311 men, 201 women) who underwent EVAR for infrarenal abdominal aortic aneurysm between 2010 and 2023. Patients were stratified by sex and by age (<80 vs. ≥80 years). The primary endpoint was long-term all-cause mortality. Secondary endpoints included perioperative outcomes, Type I endoleak incidence, and reintervention rates. Mortality predictors were assessed using Cox proportional hazards regression. Median follow-up time was 95 months. Results Women and octogenarians had significantly larger aneurysm diameters and greater aortic neck angulation (both p < 0.001). Type I endoleak incidence was significantly higher in women (26.4% vs. 11.9%, p < 0.001) and in patients ≥80 years (32.2% vs. 11.4%, p < 0.001). Cox regression demonstrated that age ≥80 years increased mortality risk 2.43-fold [hazard ratio (HR) = 2.430; 95% confidence interval: 1.430–4.127; p = 0.001], whereas sex was not an independent predictor of mortality ( p = 0.185). Discussion Octogenarians exhibited markedly higher mortality risk, and women presented with more challenging vascular anatomy and a higher rate of Type I endoleaks. These findings are consistent with reported anatomical and outcome disparities in high-risk AAA populations. Conclusion These results emphasize that tailored pre-operative planning, device selection, and long-term follow-up strategies may optimise outcomes in elderly and female patients and align with contemporary vascular surgery guidelines.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2025.1687919

Authors: Ersin Ozer, Kaptaniderya Tayfur, Melih Urkmez, Ferhat Borulu

Institution: Ordu University

Language: English

Topic: Aortic aneurysm repair treatments

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801