Variables that affect the expansion rate and rupture of abdominal aortic aneurysms
Variables that affect the expansion rate and rupture of abdominal aortic aneurysms
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DOI：
10.1111/j.1749-6632.1996.tb33298.x
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发表时间：
1996-01-01
期刊：
影响因子：
--
通讯作者：
Cronenwett, JL
中科院分区：
文献类型：
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作者：
Cronenwett, JL
腹主动脉瘤（AAA）的自然史是扩张和破裂，这是手术治疗的基础。然而，AAA在扩张率和破裂风险方面表现出相当大的差异，这使得个体患者的手术决策更加困难。尽管如此，必须做出这样的决定，严格的决策分析模型表明，破裂风险是影响这一决定的关键变量。由于扩张率是未来动脉瘤尺寸的决定因素，因此考虑扩张率和破裂风险对于了解AAA的自然史非常重要。选择性手术治疗的发展导致了大多数大型AAA的修复。此外，许多小的AAA被选择性修复，这导致在大多数未经治疗的AAA的“自然史”研究中低估了破裂风险。因此，虽然手术治疗对AAA有效，但它也阻碍了对其自然史的精确了解。幸运的是，目前正在进行两项随机试验，这将更好地定义未经治疗的小AAA的自然史。本文将回顾我们目前对AAA破裂风险和扩张率的理解。
The natural history of abdominal aortic aneurysms (AAAs) is to expand and rupture, which is the basis for surgical treatment. AAAs show considerable variation in expansion rate and rupture risk, however, which makes surgical decision making more difficult for individual patients. Nonetheless, such decisions must be made, and rigorous decision analysis models demonstrate that rupture risk is the key variable that affects this decision.’Because expansion rate is the determinate of future aneurysm size, it is important to consider both expansion rate and rupture risk to understand the natural history of AAAs. The development of elective surgical treatment has led to the repair of most large AAAs. Furthermore, many small AAAs are selectively repaired, which leads to an underestimate of rupture risk in most “natural history” studies of untreated AAAs. Thus, although surgical treatment is effective for AAAs, it has also thwarted a precise knowledge of their natural history. Fortunately, two randomized trials are currently under way which should better define the natural history of untreated small AAAs. This paper will review our current understanding of AAA rupture risk and expansion rate.