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Vascular and Endovascular Surgery
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Reviews

Prospects for the Medical Management of Abdominal Aortic Aneurysms

Eric F. Steinmetz

Celine Buckley

Department of Surgery (Section of Vascular Surgery), Washington University School of Medicine, St. Louis, MO

Robert W. Thompson

Department of Surgery (Section of Vascular Surgery); Department of Radiology; Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO; thompsonr{at}msnotes.wustl.edu

Abdominal aortic aneurysms (AAAs) are a chronic degenerative disease with life-threatening implications. While AAAs are thought to arise through a localized form of arterial wall injury superimposed on various predisposing factors, their natural history is one of progressive structural deterioration, gradual expansion, and eventual rupture. Pathologic processes contributing to the changes observed in AAAs include chronic inflammation, destructive remodeling of the extracellular matrix, and depletion of vascular smooth muscle cells. These changes result in progressive aortic dilatation accompanied by alterations in vessel geometry, redistribution of hemodynamic wall stresses, and diminished tensile strength. As outlined in this review, better understanding of the biological mechanisms underlying these changes will allow design of novel therapeutic strategies to suppress the process of aneurysmal degeneration.

Vascular and Endovascular Surgery, Vol. 37, No. 3, 151-163 (2003)
DOI: 10.1177/153857440303700301
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