Abdominal aortic aneurysm: pathogenesis and implications for management

Golledge, Jonathan;Muller, Juanita;Daugherty, Alan;Norman, Paul

Abstract

Abdominal aortic aneurysm (AAA) affects approximately 5% of elderly men and is responsible for a significant number of deaths in Western Countries. At present surgery by open or endovascular means is the only widely used therapy for this condition. In this review we examine the risk factors, serum, and genetic associations of AAA. Epidemiology studies suggest that smoking cessation and control of cholesterol and blood pressure should reduce the number of patients developing AAA. Natural history studies suggest that smoking cessation should reduce the rate of progression of AAA. Clear level 1 evidence for drug treatments of AAA are presently lacking; however, animal and human in vitro studies suggest that medication targeted at reducing inflammation and proteolysis are most likely to be beneficial, with limited data to support the use of statins, Angiotensin II inhibitors, and macrolides. Work has commenced in understanding which patients, identified by clinical, serum, and genotype, are more at risk of AAA progression and thus should be selected out for aggressive treatment. Well designed large multicenter randomized controlled trials are required to examine the medical treatment of AAA. Abdominal aortic aneurysm is associated with significant morbidity and mortality. Presently medical therapy for this condition has been neglected. This article summarises efforts to better understand the pathology of AAA to develop such treatments.

Journal

Arteriosclerosis, Thrombosis and Vascular Biology

Publication Name

N/A

Volume

ISBN/ISSN

1524-4636

Edition

N/A

Issue

Pages Count

Location

N/A

Publisher

Lippincott, Williams & Wilkins

Publisher Url

N/A

Publisher Location

Philadelphia, USA -PA

Publish Date

N/A

Url

N/A

Date

N/A

EISSN

N/A

DOI

10.1161/01.ATV.0000245819.32762.cb