Treatment strategy for patients with concomitant thoracic or abdominal aortic aneurysm and noncardiovascular disease

Therapeutic planning for patients with concomitant thoracic aortic aneurysm (TAA) or abdominal aortic aneurysm (AAA) and noncardiovascular disease such as cerebral aneurysm, carotid artery stenosis, or lung, intraabdominal or urologic tumor should be considered based on the combination of the two different conditions, the size of aneurysm, or the severity of noncardiovascular disease. The aims of this paper are to review the therapeutic plans for concomitant TAA or AAA and noncardiovascular disease. In patients with concomitant TAA or AAA and cerebral aneurysm, carotid artery stenosis, and concomitant TAA and intraabdominal or urologic tumor, the surgical procedures have usually been staged with the repair of cerebral aneurysm, or carotid artery stenosis, the resection of intraabdominal or urologic tumor performed first, followed by the repair of TAA or AAA. Simultaneous surgical treatment has been performed for most patients with concomitant TAA and lung tumor, and concomitant AAA and intraabdominal or urologic tumor. The issue of performing simultaneous pulmonary resection and repair of AAA in patients with concomitant lung tumor and AAA remains controversial. Endovascular grafting of TAA and AAA can be performed with relatively low procedure-related morbidity and mortality rates in selected patients.