Treatment of aneurysms of the abdominal aorta. Improvements and evidences

Abstract

A review of the literature on aortic aneurysms is carried out, focusing on abdominal aortic aneurysms as the most frequent location. After introducing the topic (concept, frequency, natural history of the disease, consequences -mortality-, etc.), the review focuses on the individualized treatment of this entity and the improvements obtained during the last decade, both in elective and non-elective situations, which have led to a reduction in mortality. These improvements are due to several components such as: a) early diagnosis (screening effect) and correct follow-up of aneurysms (using echo-Doppler) that have made it possible to increase more elective surgeries and reduce urgent surgeries; b) control of cardiovascular risk factors, mainly tobacco and the use of statins in this type of patient; c) the role of endovascular surgery, which has made it possible to expand surgical indications to patients previously not eligible for open surgery, including nonagenarians and some centenarians; and d) to the effect of centralizing the most complex cases (the higher the volume, the better the results).