Abdominal aortic aneurysms and concomitant neoplastic diseases. EVAR : a new option for surgical timing

Aim. Although the simultaneous occurrence of abdominal aortic aneurysm (AAA) and neoplastic disease is a rare event, the incidence of both increases with age and therefore the continuous growth of life expectancy has raised the prevalence of this association. The introduction of endovascular aneurysm repair (EVAR) in clinical practice has offered new treatment options. The authors report their experience with the introduction of E VAR. Methods. From January 2004 to June 2006, 176 patients affected by AAA were admitted - 29 had an emergent operation for rupture or fissuration, whereas 147 underwent elective surgery. Fifty of them were offered EVAR and a concomitant malignancy was present in 6 patients. In all 6 patients, EVAR was performed first. Results. We had no in-hospital mortality and no early complications. We had only one cancer-related death, 6 months after surgery. Conclusions. The introduction of EVAR has modified surgical timing in our clinical practice. When managing patients with AAA and concomitant malignancies EVAR allows treatment even in case of poor clinical conditions but still it is not the gold standard for AAA repair. Thus, it should be performed only after a thorough selection of patients who are not suitable for the combined intervention.