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Abstract
Despite declining incidence and mortality rates in many countries, the abdominal aortic aneurysm (AAA) continues to represent a life-threatening cardiovascular condition with an overall prevalence of about 2–3% in the industrialized world. While the risk of AAA development is considerably higher for men of advanced age with a history of smoking, screening programs serve to detect the often asymptomatic condition and prevent aortic rupture with an associated death rate of up to 80%. This review summarizes the current knowledge on identified risk factors, the multifactorial process of pathogenesis, as well as the latest advances in medical treatment and surgical repair to provide a perspective for AAA management.
Highlights
An aneurysm is a persistent and localized weakening and dilation of a blood vessel, typically an artery [1]
An analysis of historical and current laboratory data of patients from 12 years before their initial abdominal aortic aneurysm (AAA) diagnoses found that prior elevated total cholesterol (TC), low-density lipoprotein (LDL), and triglyceride levels were significantly associated with current AAA (ORs 1.9, 2.3, and 1.9, respectively) [77]
Two meta-analyses found conflicting results, with one confirming that increased LDL levels are associated with AAA presence [121], while the other found no such association for LDL, but found a significant effect on AAA development for elevated total cholesterol levels [122]
Summary
An aneurysm is a persistent and localized weakening and dilation of a blood vessel, typically an artery [1]. The most commonly used definition is a maximum infrarenal abdominal aortic diameter of ≥30 mm, measured by ultrasonography or computed tomography angiography (CTA) [4,5]. This threshold is based on measurements of healthy infrarenal aortic diameters and is usually more than two standard deviations above the mean diameter of 17.9–19.3 mm for men [6,7]. A dilation should be considered aneurysmal when this ratio exceeds 1.5 [1,8] This definition might be more useful for women, whose infrarenal aortic diameters measure a mean of.
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