Key result
Combined one-stage EVAR and OPCAB succeeds in two patients with unstable angina and large AAAs.
Why the study?
Simultaneous open surgery and OPCAB carries high surgical invasiveness, limiting its application in patients with coexisting AAA and CAD to urgent cases.
Is a combined one-stage procedure of EVAR and OPCAB feasible and safe in patients with unstable angina pectoris and large abdominal aortic aneurysms?
Is a combined one-stage procedure of EVAR and OPCAB feasible and safe in patients with unstable angina pectoris and large abdominal aortic aneurysms?
A combined one-stage approach of EVAR and OPCAB with IABP support is a feasible and effective clinical option for patients presenting with both unstable angina and a large abdominal aortic aneurysm.
Supports feasibility of combined EVAR-OPCAB in select high-risk patients; leaves open need for prospective trials before wider adoption.
腹部大動脈瘤（aaa）は冠動脈病変（cad）にしばしば合併することがしられている．そのような症例に対して開腹による人工血管置換術（os）とオフポンプ冠動脈バイパス術（opcab）を一期的に施行した報告が散見されるが，手術侵襲が大きいことからその適応は両者の病状がともに切迫している場合に限られる．今回われわれは手術適応のaaaを合併した不安定狭心症（uap）２症例に対して腹部大動脈ステントグラフト内挿術（evar）と大動脈バルーンパンピング（iabp）補助下のopcabを一期的に施し良好な結果を得た．瘤径の大きなaaaを合併するuap症例に対しevarとopcabを一期的に施行することは有用な手段であると考えられた．
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Motono et al. (2022) studied this question. Combined one-stage EVAR and OPCAB was successfully performed with good clinical results in two patients with unstable angina and large abdominal aortic aneurysms.
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