Editorial (hot topic:potential breakthroughs in the pharmacological treatment of abdominal aortic aneurysms).

摘要

Abdominal aortic aneurysm (AAA) is defined as a permanent segmental dilatation of the abdominal aorta, and an abdominal aorta of +3 cm is generally considered as definition of AAA. Ultrasound screening studies has found the prevalence of AAA to be 3-5 in the adult male population aged 65-74 years old. Ruptured AAA are responsible for at least 2 of all deaths in men aged 65 years old or more, but preventive elective repair is encumbered with a 30 days mortality risk of 3-6. As patients with a large AAA, at least 5.5 cm in diameter have an increased risk of rupture, elective surgical or endovascular repair is performed mainly in these patients to prevent rupture. Although a large number of asymptomatic patients with AAA have been detected during routine abdominal screening about 90 of these AAA is below 5.5 cm In contrast to large AAA, such small AAAs have a very low risk of rupture, but more than half detected by screening expands to operation demanding sizes. However, currently no well-defined treatment strategy exits for small AAA. For that reason, the development of a non-invasive therapeutic approach for treating AAA is awaited. With advances in vascular biology, the mechanism of AAA formation has been elucidated at the cellular and molecular levels, but it is still not fully understood. However, a pharmacological approach is expected to be able to offer effective prevention of the progression small AAA to operation demanding sizes or rupture. Indeed, numerous therapeutic effects of pharmacological agents have been reported in experimental models, and a few agents have been examined in human cohorts and clinical trials. This mini hot topic covers and updates five of these most promising pharmacological agents; antibiotics, statins, pleiotropic agents, antiplatelet- aggregant agents and inhibitors of mast cell degranulation.