J Korean Soc Radiol.  2010 Oct;63(4):365-370.

Endovacular Exclusion of an Abdominal Aortic Aneurysm in Patients with Concomitant Abdominal Malignancy: Early Experience

• Choi YR
• Shin HH
• Yim NY
• Oh HJ
• Chang NK
• Kim JK
• Choi SJ
• Chung SY

Abstract

PURPOSE
To assess the outcomes of endovascular aortic aneurysm repair (EVAR) for the treatment of an abdominal aortic aneurysm in patients undergoing curative surgical treatment for concomitant abdominal malignancy.
MATERIALS AND METHODS
The study included 12 patients with abdominal neoplasia and an abdominal aortic aneurysm (AAA), which was treated by surgery and stent EVAR. The neoplasm consisted of the gastric, colorectal, pancreas, prostate, and gall bladder. The follow up period was 3-21 months (mean 11.8 months). All medical records and imaging analyses were reviewed by CTA and/or color Doppler US, retrospectively.
RESULTS
Successful endoluminal repair was accomplished in all twelve patients. The mean interval time between EVAR and surgery was 58.6 days. Small amounts of type 2 endoleaks were detected in two patients (17%). One patient developed adult respiratory distress syndrome after Whipple's operation 20 days after surgery, which led to hopeless discharge. No procedure-related mortality, morbidity, or graft-related infection was noted.
CONCLUSION
Exclusion of AAA in patients with accompanying malignancy show with a relatively low procedure morbidity and mortality. Hence, endoluminal AAA repair in patients with synchronous neoplasia may allow greater flexibility in the management of an offending malignancy.

MeSH Terms

Angioplasty
Aortic Aneurysm
Aortic Aneurysm, Abdominal
Blood Vessel Prosthesis Implantation
Endoleak
Follow-Up Studies
Humans
Medical Records
Pancreas
Pliability
Prostate
Respiratory Distress Syndrome, Adult
Retrospective Studies
Stents
Urinary Bladder

Figure

• 

  Fig. 1 73-year-old male with gastric malignancy involving antrum. A. Contrast enhanced abdomen CT scan show irregular wall thickening in gastric antrum on coronal image (black arrow). The cancer is detected incidentally during abdominal aortic aneurysm follow up. B. Maximal diameter of AAA is increased from 53 mm to 74 mm on volume rendering image (white arrow head). C. Post-EVAR angiogram reveals well functioning endograft.

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