Clinical results and medical costs of thoracic endovascular aortic repair in patients over 80 years of age

Thoracic endovascular aortic repair (TEVAR) is expected to be minimally invasive, especially in older patients. However, clinical results of TEVAR in octogenarians including medical costs are limited. Between 2010 and 2016, a total of 57 patients over 80 years of age (mean age 84.1 ± 3.4 years) underwent TEVAR at our hospital. The proximal landing zone (PLZ) was zone 0 in 7 patients (12.3%), zone 1 in 10 patients (17.5%), zone 2 in 9 patients (15.8%), zone 3 in 13 patients (22.8%), and zone 4 in 18 patients (31.6%). The mean follow-up time was 23 ± 19 months (range 1–71 months). The follow-up rate was 96.5%. The hospital mortality rate was 1.8%. Stroke occurred in three patients (zone 0: 2, zone 3: 1, 5.3%). The mean hospital stay was 21.8 ± 21.4 days (range 5–98 days), and the rate of being discharged home was 84.2%. The 1-year and 3-year survival rates were 76.1% and 55.1% and the 1-year and 3-year re-intervention-free rates of the thoracic aorta were 97.6% and 94.5%, respectively. The mean total cost by the time of hospital discharge was ¥5,360,000 ± 2,360,000. The clinical results of TEVAR in patients over 80 years of age are acceptable with early postoperative recovery, low mortality and morbidity, and midterm durability.