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Endovascular, open repair yield similar benefits in patients with AAA, cancer
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Patients with cancer associated with abdominal aortic aneurysm may benefit from surgery for both conditions, with similar outcomes after endovascular and conventional open surgical techniques observed in a new study.
Researchers evaluated outcomes data collected from 27 patients with abdominal aortic aneurysm (AAA) in association with cancer who underwent surgical repair at a single institution between September 2003 and 2013. The majority of patients were men (n = 22), and prostate cancer was the most common diagnosis within the population (29% of patients). Patients underwent surgery to treat AAA after receiving treatment for cancer in 19 cases and before treatment in seven cases; one patient received concomitant treatment for both AAA and cancer. The median time between treatments was 19 months.
Nearly all patients had fusiform-shaped aneurysms (92.5%). Saccular aneurysms were observed in two patients. The mean AAA diameter was 59.07 mm (range, 39-100 mm). Most patients (70.4%) underwent endovascular aneurysm repair (EVAR), with the remaining patients undergoing open repair.
Eight patients across the two groups experienced postoperative complications. Complications were more common among those who underwent endovascular aneurysm repair (EVAR; 36.84% vs. 12.5%). Lengths of hospital stay and ICU stay were similar between the groups.
Seven patients in the EVAR group and three in the open-repair group died during the study period. No deaths related to AAA treatment occurred. Among the patients who died, the most common cause was cancer progression. The researchers calculated a probability of survival of 65.8% at 3 years and 53% at 5 years, with no difference in survival between patients who underwent EVAR or open repair.
The researchers concluded that the endovascular and open techniques were equivalent. “Patients who present [cancer] in association with AAA benefit from surgical treatment of both conditions, simultaneously or not,” they wrote. “In these cases, it is important for the treatment to be individualized, and the disease of greater severity should be treated first.” – by Adam Taliercio
Disclosure: Cardiology Today was unable to obtain relevant financial disclosures.
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