Infrarenal abdominal aortic aneurysm with concomitant urologic malignancy: treatment results in the era of endovascular aneurysm repair

Vascular. 2010 Jan-Feb;18(1):14-9. doi: 10.2310/6670.2009.00058.

Abstract

During diagnostic workup for urologic malignancies, an abdominal aortic aneurysm (AAA) is identified in a proportion of patients. In the era of open AAA repair, these patients presented a surgical dilemma with regard to the sequence of the operations: cancer treatment first or AAA repair first? Previous assessments have concluded that irrespective of the followed strategy, the early and mediumterm mortality from the two operative procedures in this patient category was significant. With the introduction of endovascular aneurysm repair (EVAR), the mortality and morbidity associated with the treatment of both pathologic conditions may be more favorable than with open aneurysm repair. The objective of this study was to assess, in an institutional series of patients receiving EVAR, the early and long-term survival and complication rates in patients with urologic malignancies. In a series of 385 patients receiving EVAR, 14 had a concomitant urologic malignancy: renal cell carcinoma (5 patients), prostate carcinoma (6 patients), and carcinoma of the bladder (3 patients). The first-month mortality was nil. Long-term survival was 80%, 83%, and 67% for the three tumor types, respectively. EVAR offers improved treatment in patients with concomitant AAA and urologic malignancy and should be considered the first choice for these patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / complications
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / mortality
  • Carcinoma, Renal Cell / complications
  • Carcinoma, Renal Cell / surgery
  • Female
  • Humans
  • Kidney Neoplasms / complications
  • Kidney Neoplasms / surgery
  • Male
  • Middle Aged
  • Patient Selection
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / surgery
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Urinary Bladder Neoplasms / complications
  • Urinary Bladder Neoplasms / surgery
  • Urogenital Surgical Procedures* / adverse effects
  • Urogenital Surgical Procedures* / mortality
  • Urologic Neoplasms / complications
  • Urologic Neoplasms / diagnostic imaging
  • Urologic Neoplasms / mortality
  • Urologic Neoplasms / surgery*