Lin Jinping, Chen Shuwei, Yao Yuanyuan, Yan Min
Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of anesthesiology, The First People's Hospital of Fuyang, Hangzhou, China.
Front Cardiovasc Med. 2023 Jul 28;10:1199804. doi: 10.3389/fcvm.2023.1199804. eCollection 2023.
Abdominal aortic aneurysms (AAAs) are characterized by localized dilation of the abdominal aorta. They are associated with several serious consequences, including compression of adjacent abdominal organs, pain, treatment-related financial expenditure. The main complication of AAA is aortic rupture, which is responsible for about 200,000 deaths per year worldwide. An increasing number of researchers are dedicating their efforts to study AAA, resulting in significant progress in this field. Despite the commendable progress made thus far, there remains a lack of established methods to effectively decelerate the dilation of aneurysms. Therefore, further studies are imperative to expand our understanding and enhance our knowledge concerning AAAs. Although numerous factors are known to be associated with the occurrence and progression of AAA, the exact pathway of development remains unclear. While asymptomatic at most times, AAA features a highly unpredictable disease course, which could culminate in the highly deadly rupture of the aneurysmal aorta. Current guidelines recommend watchful waiting and lifestyle adjustment for smaller, slow-growing aneurysms, while elective/prophylactic surgical repairs including open repair and endovascular aneurysm repair are recommended for larger aneurysms that have grown beyond certain thresholds (55 mm for males and 50 mm for females). The latter is a minimally invasive procedure and is widely believed to be suited for patients with a poor general condition. However, several concerns have recently been raised regarding the postoperative complications and possible loss of associated survival benefits on it. In this review, we aimed to highlight the current status of diagnosis and treatment of AAA by an in-depth analysis of the findings from literatures.
腹主动脉瘤(AAAs)的特征是腹主动脉局部扩张。它们会引发多种严重后果,包括压迫相邻腹部器官、疼痛以及治疗相关的财务支出。AAAs的主要并发症是主动脉破裂,全球每年约有20万人死于该病。越来越多的研究人员致力于研究AAAs,该领域也取得了显著进展。尽管迄今为止已取得了值得称赞的进展,但仍缺乏有效减缓动脉瘤扩张的既定方法。因此,有必要进一步开展研究,以加深我们对AAAs的理解并增进相关知识。虽然已知众多因素与AAAs的发生和发展相关,但其确切的发展途径仍不清楚。AAAs多数时候没有症状,但其病程极难预测,最终可能导致动脉瘤性主动脉的致命破裂。目前的指南建议,对于较小、生长缓慢的动脉瘤进行密切观察和生活方式调整,而对于直径超过特定阈值(男性为55毫米,女性为50毫米)的较大动脉瘤,则建议进行择期/预防性手术修复,包括开放修复和血管内动脉瘤修复。后者是一种微创手术,普遍认为适用于全身状况较差的患者。然而,最近有人对其术后并发症以及可能丧失的相关生存益处提出了一些担忧。在本综述中,我们旨在通过深入分析文献研究结果,突出AAAs诊断和治疗的现状。