12 - Pathogenesis of aortic aneurysms

Summary

INTRODUCTION

Over the last decade aortic aneurysm has gained increased focus for a number of reasons. Firstly, the widespread use of imaging and screening in some countries has resulted in greater detection of the condition. Secondly since the condition is much more common in the elderly the number of patients with the problem is projected to increase progressively with the rising average age of the population. Surgical and endovascular treatments have not been shown to reduce mortality for patients with small abdominal aortic aneurysms (AAAs) and thus other therapies are required to deal effectively with the large group of patients being identified with small AAAs. There is also a need to provide better prognostic information for patients with AAA by risk stratification in terms of the likelihood of complications, including AAA progression to a stage where surgery is required and also other cardiovascular complications. As a result of these current management deficiencies, there has been an explosion in studies directed at improved understanding of AAA pathogenesis. These studies have mainly consisted of investigations in animal models or assessments of human DNA, tissue or blood samples. Mice models have been particularly popular due to the ability to perform elegant interventions and assess their influence on AAA. Data from such studies has thus had a major impact on pathogenesis theories and treatment targets. However, animal models have limitations and cannot be expected to be completely comparable to human disease.