[Pathogenesis and medical treatment of the abdominal aortic aneurysm: an update]

Abdominal aorta aneurysms are quite common in elderly people, coexisting frequently with manifestations of atherosclerotic degenerative disease and in patients with already known risk factors such as hypertension, hyperlipidemia or tobacco habits. According to the most recent pathogenic concepts, the disease is caused by the inflammation of the arterial wall, leading to the destruction of elastin, and apoptosis of the smooth muscle cells of the media, associated to biomechanical factors, rendering the aortic cylinder into a sphere, with progressive expansion, coursing with growing risks of rupture, often fatal. The enormous progress noticed in the field of cellular and molecular biology and a better understanding of the intimal mechanisms involved in the pathogenesis of the disease, together with the new achievements occurred in pharmacotherapy and genetic therapy, will be able to offer in the near future, the creation of new alternatives for the medical management of this entity, preventing and controlling its progressive and expansive nature, as well as the severe and even lethal complications that can cause. In this paper the author makes an update on the new etiopathogenic concepts and new therapeutic modalities that have been tested in the medical management of the abdominal aortic aneurysm.