Small abdominal aortic aneurysms expand at 0.25 to 0.35 cm/y, highlighting the need for new medical treatments to reduce expansion by >50% and prevent reaching the 5.5-cm surgical threshold.
Current management of small abdominal aortic aneurysms relies on ultrasound surveillance until reaching 5.5 cm, highlighting an unmet need for medical therapies to reduce expansion rates.
Small abdominal aortic aneurysms, up to 5.5 cm in diameter, are very common. Ultrasonography is the most cost-effective method of detecting these aneurysms and keeping them under surveillance, because the natural history is 1 of continued expansion. The expansion rate is in the range 0.25 to 0.35 cm/y and is fastest in current smokers. From a study of expansion rates, it has been possible to formulate guidelines for the intervals at which surveillance should occur. Although the evidence from randomized trials indicates that early, open, elective surgery for small aneurysms does not save lives, when aneurysms exceed 5.5 cm in diameter, either open or endovascular surgery is recommended. To prevent small aneurysms reaching the 5.5-cm threshold, new treatments to reduce the expansion rate by >50% need to be designed, based on the underlying pathologic processes: proteolysis and inflammation. Any proposed treatments, including statins, will need to be tested in clinical trials.
Powell et al. (Tue,) conducted a review in Small abdominal aortic aneurysms. Small abdominal aortic aneurysms expand at 0.25 to 0.35 cm/y, highlighting the need for new medical treatments to reduce expansion by >50% and prevent reaching the 5.5-cm surgical threshold.
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