To observe the clinical efficacy of endoluminal isolation in the treatment of elderly abdominal aortic aneurysm and to discuss the principles of prevention and treatment of postoperative complications. Methods Eight patients with abdominal aortic aneurysm of advanced age, all of whom were over 80 years old and had other organ diseases, were treated by intracavitary isolation with Zenith stent, and postoperative complications were counted to summarize the treatment experience. The average hospital stay was 13.2 d, and the postoperative hospital stay was 7 d. In the follow-up of spiral CT from 3 to 6 months after surgery, thrombosis was seen in all aneurysms, and no complications such as stent displacement and significant endoleaks occurred. Conclusion Endoluminal isolation for the treatment of elderly abdominal aortic aneurysm has the advantages of reliable technique, small trauma, rapid postoperative recovery and high success rate. For patients with abdominal aortic aneurysms (AAA) of advanced age, surgical treatment is relatively conservative because of the high risk of surgery due to the high number of co-morbidities and poor general condition of the patients themselves. In recent years, with the increasing maturity of surgical techniques for abdominal aortic aneurysms, the improvement of preoperative evaluation and postoperative monitoring, and especially the flourishing of endoluminal treatment, these elderly patients have been given the opportunity to receive surgical treatment and to be cured. A total of 8 patients aged 80-90 years with abdominal aortic aneurysm underwent endoluminal treatment in our hospital from 2005 to 2008, which is reported below. All 8 cases were male, aged 80-87 years, with an average age of 83.7 years. The aneurysms were ≥5.5 cm in diameter, and all patients underwent endoluminal isolation. Among them, 3 cases had symptomatic abdominal aortic aneurysm. The preoperative diagnosis was combined coronary artery disease (including myocardial ischemia) in 3 cases (37.4%), hypertension in 6 cases (75%), abnormal pulmonary function in 2 cases (25%), and history of stroke in 1 case (12.5%). The Zenith bifurcated graft system with membrane stent was used in all 8 cases. The release system was placed through the common femoral artery bilaterally in all 8 cases. The stents were successfully placed below the opening of the renal artery in all 8 patients, with 1 stent placed and 7 stents placed in 2 cases. In one case, the AAA aneurysm was not satisfactorily closed after the release of the first stent, and a proximal endoleak of the stent occurred, and the second tubular stent (30m in diameter and 4cm in length) was inserted into the endoleak to achieve satisfactory closure. In the remaining 7 cases, the AAA tumor was basically closed without any serious complications such as endoleaks, tumor rupture, or renal failure, and there was no revision surgery and no perioperative death. The success rate was 100%. No residual endoleaks were detected by postoperative imaging. Postoperative complications included cardiac arrhythmia (1 case), post-abdominal aortic isolation syndrome (3 cases), and transient renal hypoperfusion (2 cases). Eight patients were treated accordingly and discharged successfully. The average number of hospital days was 13.2 d. The average number of hospital days after endoluminal isolation was 7 d. The postoperative spiral CT angiography was followed up for 3-6 months, and the aneurysm lumen was significantly reduced, intracavitary thrombus was formed, and the stent was unobstructed without endoleaks or displacement. There is no unified diagnostic standard for aneurysm, but it is generally believed that aneurysm can be diagnosed if a segment of artery is larger than 1.5 times its normal diameter. The most dangerous complication of AAA is rupture of the aneurysm, which can lead to rapid death. The most dangerous complication of AAA is rupture, which can lead to rapid death. If AAA with a diameter of 5 cm or more is not treated surgically, the spontaneous rupture rate is as high as 50% within 2 years [5]. Currently, the mortality rate is 4%-6% for elective surgery, 19% for emergency surgery, and over 50% for post-rupture emergency surgery [5], and over 90% for combined pre-admission mortality. In 1991, Parodi in Argentina first reported the successful application of endovascular graft exclusion (EVGE) for the treatment of abdominal aortic aneurysms, which opened a new era of minimally invasive treatment for AAA. It has become one of the focal points of research in the cardiovascular field because of its advantages of less invasion and fewer complications. In the last 2 years of case review, we have had 8 consecutive patients of advanced age without death. Our treatment experience includes: (1) Complete preoperative examination, detailed preoperative discussion and preparation: Since the establishment of our department, we have formed a set of norms for the diagnosis and treatment of abdominal aortic aneurysm, and preoperative examination of three major routine, liver and kidney function, coagulation function, electrocardiogram, chest X-ray, etc., as well as cardiac ultrasound, respiratory function to understand the cardiopulmonary function reserve, and evaluation of each important organ of the patient. Ultrasound was used to measure the internal diameter of the femoral and iliac arteries in order to determine whether the femoral artery was suitable for introduction into the system before surgery. CTA of the abdominal aorta was performed to understand the morphology, size, and neck length of the abdominal aortic aneurysm and to determine the parameters of the graft. Creatinine clearance was performed to determine the renal function. Before the operation, we routinely asked the ICU, anesthesiology and imaging departments to consult with each other, and made relevant treatment and management suggestions, and emphasized the possible serious conditions and some matters that needed attention during the intraoperative and postoperative treatment to strengthen inter-departmental collaboration. If the preoperative ejection fraction is less than 50 or the preoperative respiratory function is severely impaired, it is considered an absolute contraindication to surgery. (2) Close intraoperative monitoring, smooth intraoperative anesthesia, fine, accurate and rapid surgical treatment: Even if the preoperative examination of elderly patients does not reveal any obvious organ decompensation, their tolerance to surgery will be reduced. Therefore, intraoperative organ protection is extremely important. If preoperative examination reveals renal decompensation, we use Vespak as a contrast agent. At the beginning of the procedure, antibiotics were given intravenously to prevent infection. Intraoperative imaging is performed to recheck the size and shape of the aneurysm, the width of the anchorage zone, and other indicators, and to compare them with the preoperative estimate. The blood pressure was kept as stable as possible during the operation. Operate carefully, concisely and quickly to reduce surgical injuries. (3) Close postoperative monitoring and active control of inflammatory response syndrome: SIRS (systematic inflammation reaction syndrome) is considered to be an early manifestation of MODS. It has been suggested that SIRS can be an early warning of postoperative complications and organ dysfunction, and early control of SIRS can stop the evolution of organ dysfunction to functional failure [6]. The quantification of SIRS indicators and the change in SIRS values can determine the duration of ICU treatment [7].SIRS in surgical practice is mainly related to factors such as the duration of surgery, the amount of blood transfusion, the amount of tissue removed and the degree of disturbance to the physiological state after reconstructive surgery. We routinely send our elderly patients to ICU after surgery and decide the length of stay in ICU according to their condition. Our clinical observation also found that the peak of SIRS in patients was mostly around 72h postoperatively. Our postoperative management experience includes: frequent communication between the surgeon and the ICU, so that the ICU physician can have an understanding of the patient’s intraoperative condition and the conditions that need attention in the postoperative specialty; short-term use of small doses of hormones to suppress intracavitary isolation of the postoperative syndrome; if there is a persistent decline in platelets, platelets can be repeatedly injected at 20U each time to make the platelets greater than 50×109/L; attention to the correction of anemia, so that the hematocrit The use of broad-spectrum antibiotics to prevent infection, etc. Although ruptured abdominal aortic aneurysms have a high mortality rate, we believe that advanced age is not a contraindication to surgery. Although ruptured abdominal aortic aneurysms have a high mortality rate, we believe that advanced age is not a contraindication to surgery. As a minimally invasive procedure, endoluminal isolation of abdominal aortic aneurysms has its own advantages, and should be the preferred treatment for elderly patients with abdominal aortic aneurysms. Compared with conventional surgery, EVGE has the advantages of simplicity, minimally invasive, rapid postoperative recovery, few complications, and high success rate, and should be considered as the preferred treatment for subrenal AAA. Based on our preliminary experience of clinical application, it is especially suitable for elderly high-risk AAA patients with combined vital organ dysfunction who cannot tolerate conventional open surgery.