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<p>Abdominal aortic aneurysms (AAA) represent a&#xa0;clinically relevant and potentially life-threatening condition, particularly in older and multimorbid patients. Elective repair greatly reduces the risk of rupture and improves the chances of survival. Endovascular aneurysm repair (EVAR) is generally the preferred treatment option in suitable candidates due to its minimally invasive nature and lower perioperative morbidity compared to open repair; however, treatment decisions should not rely solely on aneurysm size but should also always include the patient’s overall clinical condition. Frailty, sarcopenia and poor nutritional status are key risk factors that influence the postoperative outcomes. Geriatric assessment tools such as the Clinical Frailty Scale (CFS), Risk Analysis Index (RAI) and Geriatric Nutritional Risk Index (GNRI) enable a&#xa0;structured risk stratification and support individualized treatment strategies.</p><p>In very old and frail patients the operative risk can exceed the natural risk of rupture of the aneurysm. Therefore, careful, multidisciplinary and patient-centered decision-making is essential to optimize clinical outcomes.</p>

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Die Behandlung des Bauchaortenaneurysmas im Alter

  • 期刊论文

  • 发表日期：

    2026年7月27日

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  • Artis Knapsis

摘要

Abdominal aortic aneurysms (AAA) represent a clinically relevant and potentially life-threatening condition, particularly in older and multimorbid patients. Elective repair greatly reduces the risk of rupture and improves the chances of survival. Endovascular aneurysm repair (EVAR) is generally the preferred treatment option in suitable candidates due to its minimally invasive nature and lower perioperative morbidity compared to open repair; however, treatment decisions should not rely solely on aneurysm size but should also always include the patient’s overall clinical condition. Frailty, sarcopenia and poor nutritional status are key risk factors that influence the postoperative outcomes. Geriatric assessment tools such as the Clinical Frailty Scale (CFS), Risk Analysis Index (RAI) and Geriatric Nutritional Risk Index (GNRI) enable a structured risk stratification and support individualized treatment strategies.

In very old and frail patients the operative risk can exceed the natural risk of rupture of the aneurysm. Therefore, careful, multidisciplinary and patient-centered decision-making is essential to optimize clinical outcomes.