Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

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

복부 대동맥류와 복부 장기 악성종양에 동시에 이환된 환자의 혈관 내 스텐트 삽입결과: 초기 경험

  • Choi, You-Ri (Department of Radiology, Chonnam National University Hwasun Hospital) ;
  • Shin, Hyo-Hyun (Department of Radiology, Chonnam National University Hospital) ;
  • Yim, Nam-Yeol (Department of Radiology, The Armed Forces Yangju Hospital) ;
  • Oh, Hyun-Jun (Department of Radiology, Chonnam National University Hospital) ;
  • Chang, Nam-Kyu (Department of Radiology, Chonnam National University Hwasun Hospital) ;
  • Kim, Jae-Kyu (Department of Radiology, Chonnam National University Hospital) ;
  • Choi, Soo-Jin-Na (Department of Surgery, Chonnam National University Hospital) ;
  • Chung, Sang-Young (Department of Surgery, Chonnam National University Hospital)
  • 최유리 (화순전남대학교병원 영상의학과) ;
  • 신효현 (전남대학교병원 영상의학과) ;
  • 임남열 (국군양주병원 영상의학과) ;
  • 오현준 (전남대학교병원 영상의학과) ;
  • 장남규 (화순전남대학교병원 영상의학과) ;
  • 김재규 (전남대학교병원 영상의학과) ;
  • 최수진나 (전남대학교병원 외과학과) ;
  • 정상영 (전남대학교병원 외과학과)
  • Received : 2010.02.17
  • Accepted : 2010.06.20
  • Published : 2010.10.01
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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.

목적: 복부 대동맥류와 복부 장기 악성 종양에 동시에 걸린 환자에서 복부 대동맥류에 대해 시행한 인조혈관스텐트삽입술의 초기 경험에 대해 평가하고자 하였다. 대상과 방법: 복부 대동맥류와 복부 장기 악성 종양으로 인조혈관스텐트삽입술과 종양에 대한 수술적 치료를 받은 환자 12명을 연구 대상으로 하였으며, 이 중 8명은 수술 전에 스텐트를 삽입하였고 4명은 수술 후에 삽입하였다. 나이는 53-82세(평균 71세)이며 남자 11명, 여자 1명이었다. 복부 장기 악성 종양 종류는 위, 결장직장, 췌장, 전립선, 담낭 등이었다. 추적 관찰 기간은 3-21개월(평균 11.8개월)로 전산화단층동맥조영술 또는 색도플러초음파로 검사하였다. 결과: 12명 환자 모두에게 성공적으로 인조혈관스텐트삽입술을 시행하였으며, 인조혈관스텐트 삽입술과 종양 수술과의 시간 간격은 6일에서 180일(평균 58.6일) 이였다. 추적 관찰 기간 도중 2명(17%)의 환자에서 제2형 내강 누출이 있었다. 췌장암 환자 1명에서 수술받은 20일 후 급성성인호흡곤란증후군이 발생하여 회복 가능성 없어 퇴원하였다. 시술 관련 사망이나 스텐트감염 등은 없었다. 결론: 복부 대동맥류와 복부 장기 악성 종양에 동시에 걸린 환자에서 복부 대동맥류에 대한 인조혈관스텐트삽입술을 이용한 혈관 내 중재적 치료법은 낮은 사망률과 적은 합병증을 보이며, 두 질환을 동시에 갖는 환자에서 치료 계획을 세우는 데 있어 도움을 줄 것으로 생각한다.

Keywords

References

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