Journal List > J Korean Soc Radiol > v.63(4) > 1086837

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Choi, Shin, Yim, Oh, Chang, Kim, Choi, and Chung: Endovacular Exclusion of an Abdominal Aortic Aneurysm in Patients with Concomitant Abdominal Malignancy: Early Experience
Interventional Radiology
Original Article

Journal of the Korean Society of Radiology 2010; 63(4): 365-370.

Published online: 31 October 2010

DOI: https://doi.org/10.3348/jksr.2010.63.4.365

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

You Ri Choi, M.D., Hyo Hyun Shin, M.D.2, Nam Yeol Yim, M.D.3, Hyun-Jun Oh, M.D.2, Nam Kyu Chang, M.D., Jae Kyu Kim, M.D.2, Soo Jin Na Choi, M.D.4, Sang Young Chung, M.D.4

1Department of Radiology, Chonnam National University Hwasun Hospital, Korea.

2Department of Radiology, Chonnam National University Hospital, Korea.

3Department of Radiology, The Armed Forces Yangju Hospital, Korea.

4Department of Surgery, Chonnam National University Hospital, Korea.

Address reprint requests to: Nam Kyu Chang, M.D., Department of Radiology, Chonnam National University Hwasun Hospital 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do 519-763, Korea. Tel. 82-61-379-7112, Fax. 82-61-379-7133, tosouth9@hanmail.net

Received 17 February 2010       Accepted 20 June 2010

Copyright © 2010 The Korean Society of Radiology

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.

Keywords: Aortic Aneurysm, Abdominal, Angioplasty, Neoplasm/Complication, Blood Vessel Prosthesis Implantation

Figures and Tables

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.
jksr-63-365-g001
Table 1

Patient Demographics

jksr-63-365-i001

Note.─ *First 8 people written bold stroke were the patient underwent EVAR first, followed by operation for abdominal neoplasia. **LAR = low anterior resection, CCRT = concomitant chemoradiation therapy, RHC = right hemi-colectomy, LCS = laparoscopic cholecystectomy, PPPD = pylorus-preserving pancreatoduodenectomy, TUR-P = transurethral resection of the prostate, RSG = radical subtotal gastrectomy, EMR = endoscopic mucosal resection

Table 2

Long-term Results

jksr-63-365-i002

Note.─ †Interval: day between EVAR and malignancy surgery or between malignancy surgery and EVAR

‡Excluder® (Gore), Zenith® (Cook)

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