Madika Anne-Laure, Mounier-Vehier Claire, Azzaoui Richard
CHU de Lille, université de Lille, institut cœur-poumon, médecine vasculaire et HTA, EA 2694 (santé publique : épidémiologie et qualité des soins), 59000 Lille, France.
CHU de Lille, université de Lille, institut cœur-poumon, médecine vasculaire et HTA, EA 2694 (santé publique : épidémiologie et qualité des soins), 59000 Lille, France.
Presse Med. 2018 Feb;47(2):161-166. doi: 10.1016/j.lpm.2018.01.019. Epub 2018 Feb 28.
Diagnosis of abdominal aortic aneurysm (AAA) at preoperative stage is increasingly frequent. It carries both a local risk of rupture and an increased global cardiovascular risk. Patients with AAA have indeed a 20 times higher risk of dying from myocardial infarction or stroke than from a ruptured aneurysm. Cardiovascular risk factors control is therefore essential, particularly smoking cessation. Treatment in cardiovascular prevention is also warranted. Seeking for atheromatous sites is needed as they determine prognosis. Evidence of the benefit of medical treatment to slow AAA growth is still lacking. In practice, it is recommended to prescribe statins and angiotensin converting enzyme inhibitor to prevent cardiovascular events. These preventive measures are as well necessary to improve postoperative prognosis and must be continued after surgical repair. A vascular medical and surgical cooperation is primordial to enhance comprehensive management of patients with AAA.
腹主动脉瘤（AAA）在术前阶段的诊断越来越频繁。它既有局部破裂风险，又有整体心血管风险增加的问题。腹主动脉瘤患者死于心肌梗死或中风的风险确实比死于动脉瘤破裂的风险高20倍。因此，控制心血管危险因素至关重要，尤其是戒烟。心血管预防治疗也很有必要。需要寻找动脉粥样硬化部位，因为它们决定预后。目前仍缺乏药物治疗减缓腹主动脉瘤生长有益效果的证据。在实践中，建议使用他汀类药物和血管紧张素转换酶抑制剂来预防心血管事件。这些预防措施对于改善术后预后也很必要，并且在手术修复后必须继续。血管内科和外科的合作对于加强腹主动脉瘤患者的综合管理至关重要。
