Pharmacological Interventions to Attenuate the Expansion of Abdominal Aortic Aneurysm (AAA) - A Systematic Review

Introduction: Is it possible by pharmacological methods to attenuate the expansion rate of abdominal aortic aneurysms? Method: An Internet-based systematic literature search was performed to identify published reports on pharmacological methods to influence aneurysmal expansion rate. Results: Of an original 450 articles, 21 remained to review: they included 15 cohort studies with 12,321 patients and seven randomised clinical trials (RCTs) with 1069 patients. Most studies are performed without a pre-study sample size calculation. There is no consistent pattern of pharmacological influence on expansion rate, but statins, non-steroidal anti-inflammatory drugs (NSAIDs) and macrolides should be further evaluated. Conclusion: Properly designed RCTs are needed before conclusions can be drawn on the possibility to pharmacologically attenuate aneurysmal expansion and prevent rupture. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.