Abdominal aortic aneurysm and concomitant malignancy: what treatment?

Area of Science:

• Vascular Surgery
• Surgical Oncology
• Abdominal Aortic Aneurysm (AAA)

Background:

• The co-occurrence of neoplasm and abdominal aortic aneurysm (AAA) is rare but poses significant therapeutic challenges.
• Colon cancer is the most frequently associated neoplasm with AAA in reported cases.

Purpose of the Study:

• To evaluate therapeutic strategies for patients with concurrent abdominal aortic aneurysm (AAA) and neoplasm.
• To assess the safety and efficacy of one-stage surgery versus endovascular treatment for AAA in cancer patients.

Main Methods:

• Retrospective analysis of 127 patients with AAA between 1990 and 2004, with 8 cases showing associated neoplasm.
• Surgical interventions included one-stage surgery, two-stage surgery, and endovascular treatment with endografts.
• One case involved a pancreatic cancer diagnosed post-AAA repair, deemed inoperable due to advanced stage.

Main Results:

• No prosthetic infections or major complications were observed in the treated patients.
• Endovascular treatments for AAA were successful, followed by timely cancer resection without complications.
• One-stage surgery was identified as a safe option for managing combined AAA and cancer.

Conclusions:

• Prognosis for patients with AAA and neoplasm is primarily determined by the cancer stage.
• Treatment timing should prioritize the pathology with the highest risk of short-term complications.
• Endovascular AAA repair followed by cancer resection offers a viable and safe therapeutic strategy.