Lifestyle changes and medical therapy in slowing the growth of small abdominal aortic aneurysms

Mihailo Nešković, Nenad Đukić, S. Tanasković, S. Babić, P. Matic, D. Nenezić, P. Gajin, Đ. Radak
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Abstract

The goal of our review was to evaluate the impact of lifestyle changes and medical therapy in slowing the growth of small abdominal aortic aneurysms (AAA), as well as to introduce current ideas for future treatment. No viable evidence was found that medical therapy can slow the growth of small AAAs. The beneficial role of propranolol, angiotensin-converting enzyme inhibitors and doxycycline in reducing the growth rate of AAA was ruled out by randomized controlled studies, whereas the efficiency of statins, macrolides and anti-platelet therapy remains controversial. On the other hand, smoking cessation is the only established lifestyle change that was effective in impeding the AAA expansion. Also, there are a considerable number of novel therapeutic strategies related to the problem, which still need to be evaluated in clinical trials, including administration of Cyclosporine A, gene therapy and mesenchymal stem cell treatment
生活方式的改变和药物治疗对减缓小腹主动脉瘤生长的影响
本综述的目的是评估生活方式改变和药物治疗对减缓小腹主动脉瘤(AAA)生长的影响,并为未来的治疗介绍当前的想法。没有可靠的证据表明药物治疗可以减缓小AAAs的生长。随机对照研究排除了普萘洛尔、血管紧张素转换酶抑制剂和强力霉素对降低AAA生长速率的有益作用,而他汀类药物、大环内酯类药物和抗血小板治疗的有效性仍存在争议。另一方面,戒烟是唯一能有效阻止AAA扩张的生活方式改变。此外,有相当多的新治疗策略与该问题相关,仍需要在临床试验中进行评估,包括环孢素a的施用,基因治疗和间充质干细胞治疗
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