[Etiopathogenesis, diagnosis and treatment of aneurysms of the abdominal aorta in the year 2000].
The author presents an account of the present status in the sphere of epidemiology, etiopathogenesis, diagnosis and treatment of an aneurysm of the abdominal aorta (AAA). Based on the experience from his own department and data in the literature he summarizes recent findings in particular on the etiopathogenesis and treatment of AAA. Research on the etiopathogenesis of AAA is focused at present mainly on inflammatory processes in the aortal wall leading to subsequent destruction of the intercellular matrix. An important part is pleayed by inflammatory cells (macrophages, T and B lymphocytes), smooth muscle cells of the media and fibroblasts. Important information molecules in the inflammatory process are cystokines. However the causal factor or factors which start the process are still unknown. Hypertension and smoking are important risk factors for the development of AAA. The contemporary rapidly developing trend of treatment of AAA are endovascular operations which have however technical limitations and so far long-term results are not known. An obvious advantage, as compared with classical surgical treatment, is the sparing operation and the short hospitalization of the patient. A certain disadvantage is the necessity of permanent follow up of the patient by duplex sonography or CT and a certain percentage of complications associated with this technique which calls for subsequent endovascular or surgical operations. It is therefore difficult to compare the economic cost of endovascular and surgical treatment. The objective of research, diagnostic and therapeutic efforts in the near future should be reduction of the incidence of AAA ruptures (40% of all AAA is manifested first by rupture) and better therapeutic results (the mortality is at present 30-70%).
Chirurgická klinika FN Plzen-Lochotín.
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D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans