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Medikamentöse Therapie zur Risikoreduktion und Progressionshemmung nicht interventionspflichtiger abdomineller Aortenaneurysmen

Medicinal treatment for risk reduction and progression inhibition of small abdominal aortic aneurysms

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Zusammenfassung

Hintergrund

Ultraschall-Screening-Untersuchungen sind hocheffektiv in der Detektion von abdominellen Aortenaneurysmen (AAA) bei Männern über 65 Jahre. Patienten mit kleinem AAA (Diameter < 5,5 cm) bedürfen noch keiner Ausschaltung, weisen jedoch aufgrund bestehender Komorbiditäten ein erhöhtes kardiovaskuläres Mortalitätsrisiko auf, welches die Rupturrate deutlich übersteigt.

Fragestellung

Es wird die Effektivität medikamentöser Behandlungsansätze auf das allgemeine kardiovaskuläre Risikos sowie die Wachstums- und Rupturrate bei Patienten mit kleinen AAA analysiert.

Material und Methode

Darlegung und Diskussion der zugrundeliegenden Literatur.

Ergebnisse

Statine, β-Blocker und ACE-Hemmer senken die kardiovaskuläre Mortalität bei Patienten mit AAA. Statine führen zudem zu einer Reduktion der Wachstumsrate von abdominellen Aneurysmen.

Schlussfolgerungen

Screeningprogramme müssen Strategien implementieren, um die gesamte kardiovaskuläre Prognose von Patienten mit kleinen AAA zu verbessern.

Abstract

Background

An ultrasound screening examination is highly effective in the detection of abdominal aortic aneurysms (AAA) in males above the age of 65 years. Patients with small AAAs (diameter < 5.5 cm) do not benefit from endovascular or open surgical aneurysmal repair but have a dramatically increased cardiovascular mortality risk due to existing comorbidities which by far exceeds the aneurysmal rupture rate.

Objectives

The effectiveness of medicinal treatment approaches on the overall cardiovascular risk and on the growth and rupture rate of small AAAs was analyzed.

Material and methods

This article presents and discusses the currently available literature on the effectiveness of medicinal treatment of small AAAs.

Results

Statins, beta blockers and angiotensin-converting enzyme (ACE) inhibitors reduce cardiovascular mortality in patients with AAAs and statins also reduce the growth rate of AAAs.

Conclusion

Screening programs must implement strategies to improve total cardiovascular prognosis of patients with small AAAs.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Mahlmann, R. Rodionov und N. Weiss geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Universitäts GefäßCentrum Dresden, Bereich Angiologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland

    A. Mahlmann, R. Rodionov &  N. Weiss

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  1. A. Mahlmann
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  3. N. Weiss
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Correspondence to N. Weiss.

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Mahlmann, A., Rodionov, R. & Weiss, N. Medikamentöse Therapie zur Risikoreduktion und Progressionshemmung nicht interventionspflichtiger abdomineller Aortenaneurysmen. Gefässchirurgie 19, 568–572 (2014). https://doi.org/10.1007/s00772-014-1349-3

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  • DOI: https://doi.org/10.1007/s00772-014-1349-3

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