Study Suggests New Application for Endovascular Grafts, According to Presentation at 93rd AATS Annual Meeting
Newswise — Minneapolis, MN, May 8, 2013 – Tumors have the potential to grow locally and invade neighboring organs. Some chest tumors may invade one of the great vessels of the body, the aorta. Surgical removal of these tumors is very challenging and necessitates the support of a heart-lung machine. Therefore there is an increased risk of complication and death. In a small series of patients, placing a stent within the aorta facilitated the subsequent removal of tumor and eliminated the need for heart-lung bypass. A report of these results is presented by Stéphane Collaud, MD, MSc, at the Emerging Technology and Techniques Forum of the 93rd AATS Annual Meeting in Minneapolis on May 8, 2013.
Endovascular grafts are inserted into blood vessels in the groin, and then threaded through the vasculature until they reach the aorta, where they prop up the vascular wall and keep the lumen open. Endovascular thoracic stent-grafts are indicated for use in aortic aneurysms, dissections, traumatic injuries, and rupture of the aorta. However, worldwide, these vessel prostheses have only been used anecdotally for helping in the removal of tumors invading the aorta.
In this retrospective single-center study at the University of Toronto, five patients with tumors infiltrating the aorta received an aortic endograft 1-9 days prior to tumor resection. Three patients had non-small cell lung carcinomas and two had sarcomas. The proximal end of the stent-graft was placed in the aortic arch or descending aorta. The tumor was resected en bloc (as one unit) in all patients and was combined with resection of the chest wall and spine in four of five patients.
“We describe the off-label use of endografts in the oncological setting. We suggest that the indication for thoracic aortic endografts could be extended to specific oncological cases,” says Dr. Collaud, a thoracic surgeon affiliated with Toronto General Hospital, University Health Network, and the University of Toronto. “This minimally invasive approach allowed safer removal of complex tumors invading the aorta without the need for a heart-lung machine.”
After 9 to 62 months, all patients had survived and remained free of disease. There were no endograft-related complications. # # #
NOTES FOR EDITORS“Thoracic Aortic Endografting Facilitates the Resection of Tumors Infiltrating the Aorta,” by S. Collaud, T.K. Waddell, K. Yasufuku, G. Oreopoulos, R. Rampersaud, B. Rubin, G. Roche-Nagel, S. Keshavjee, and M. de Perrot. Presentation at the 93rd AATS Annual Meeting. May 4-8, 2013. Minneapolis, MN, during the Emerging Technologies and Techniques Forum on May 8, 7:44 AM CT. http://aats.org/annualmeeting/
For more information contact Nicole Baritot, Associate Managing Editor, AATS Scientific Publications, at +1 978-299-4520 or [email protected]. Journalists wishing to conduct author interviews should contact Dr. de Perrot at 416-340-5549 or [email protected] or Dr. Collaud at +1 647 502 2003 or [email protected].
Stéphane Collaud, MD, MSc, was supported for this work by the “American Association for Thoracic Surgery’s Evarts A. Graham Memorial Traveling Fellowship.”
ABOUT THE AUTHORSS. Collaud, MD, MSc, Division of Thoracic Surgery, Sprott Department of Surgery, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON, CanadaT.K. Waddell, MD, PhD, Division of Thoracic Surgery, Sprott Department of Surgery, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON, Canada K. Yasufuku, MD, PhD, Division of Thoracic Surgery, Sprott Department of Surgery, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON, CanadaG. Oreopoulos, MD, MSc, Division of Vascular Surgery, Sprott Department of Surgery and the Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON, CanadaR. Rampersaud, MD, Division of Orthopedic Surgery, Sprott Department of Surgery, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON, Canada B. Rubin, MD, PhD, Division of Vascular Surgery, Sprott Department of Surgery and the Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON, CanadaG. Roche-Nagel, MD, Division of Vascular Surgery, Sprott Department of Surgery and the Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON, CanadaS. Keshavjee, MD, MSc, Division of Thoracic Surgery, Sprott Department of Surgery, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON, CanadaM. de Perrot, MD, MSc, Division of Thoracic Surgery, Sprott Department of Surgery, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON, Canada
ABOUT THE AMERICAN ASSOCIATION FOR THORACIC SURGERY (AATS)The American Association for Thoracic Surgery (AATS) is an international organization of over 1,300 of the world’s foremost thoracic and cardiothoracic surgeons, representing 35 countries. AATS encourages and stimulates education and investigation into the areas of intrathoracic physiology, pathology and therapy. Founded in 1917 by a respected group of the last century’s earliest pioneers in the field of thoracic surgery, the AATS’ original mission was to “foster the evolution of an interest in surgery of the Thorax.” One hundred years later, the AATS continues to be the premiere association among cardiothoracic surgeons. The purpose of the Association is the continual enhancement of the ability of cardiothoracic surgeons to provide the highest level of quality patient care. To this end, the AATS encourages, promotes, and stimulates the scientific investigation and study of cardiothoracic surgery. Visit www.aats.org.
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