Abdominal aortic aneurysm medical therapy

Abdominal Aortic Aneurysm Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Aarti Narayan, M.B.B.S [3]

Medical therapy

Management

• Risk factor modification
  • Smoking cessation
• ACEI, beta blockers, statins, aspirin, antibiotics for possible chlamydia infection
• Assess for coronary, carotid and peripheral vascular disease
• Surveillance:
  • 4 to 5.4 cm - monitor every 6 to 12 months
  • 3 to 4 cm - monitor every 2 to 3 years

Acute pharmacotherapies

• Antimetalloproteases such as doxycycline and roxithromycin may halt aneurysm expansion
• Similarly, non-steriod anti inflammatory drugs have shown to be beneficial in small studies
• Beta blockers have numerous benefits in patients with cardiovascular disease

  • Reduce aortic complications in patients with Marfan syndrome
  • Slow progression of AAAs in hypertensive patients
  • In the absence of other indications for beta blockers, the evidence is insufficient to recommend using them routinely for the sole purpose of slowing atherosclerotic aneurysm growth