title: Medical management of abdominal aortic aneurysms.
abstract: Abdominal aortic aneurysms (AAA) are the most common arterial aneurysms. Endovascular or open surgical aneurysm repair is indicated in patients with large AAA ≥ 5.5 cm in diameter as this prevents aneurysm rupture. The presence even of small AAAs not in need of immediate repair is associated with a very high cardiovascular risk including myocardial infarction, stroke or cardiovascular death. This risk by far exceeds the risk of aneurysm rupture. These patients therefore should be considered as high-risk patients and receive optimal medical treatment and life-style modification of their cardiovascular risk factors to improve their prognosis. In addition, these patients should be followed-up for aneurysm growth and receive medical treatment to decrease aneurym progression and rupture rate. Treatment with statins has been shown to reduce cardiovascular mortality in these patients, and also slows the rate of AAA growth. Use of beta-blockers, ACE inhibitors and AT1-receptor antagonists does not affect AAA growth but may be indicated for comorbidities. Antibiotic therapy with roxithromycin has a small effect on AAA growth, but this effect must be critically weighed against the potential risk of wide-spread use of antibiotics.
authors.affiliation: University Center for Vascular Medicine and Department of Medicine III, Section Angiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Weiss
authors.affiliation: University Center for Vascular Medicine and Department of Medicine III, Section Angiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
authors.forename: Roman N
authors.initials: RN
authors.lastname: Rodionov
authors.affiliation: University Center for Vascular Medicine and Department of Medicine III, Section Angiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
authors.forename: Adrian
authors.initials: A
authors.lastname: Mahlmann
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D001019:Aortic Rupture / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002317:Cardiovascular Agents
keywords: Abdominal aortic aneurysm; cardiovascular risk; medical therapy; statins