Nanomaterials in abdominal aortic aneurysm: From targeted therapy to smart vascular repair

Abdominal aortic aneurysm (AAA), defined as a permanent and often asymptomatic dilatation of the abdominal aorta, poses a significant threat of rupture with high mortality, yet lacks effective pharmacological interventions for stabilisation or regression. Current surgical options are invasive or require strict anatomical suitability, leaving patients with small aneurysms under passive surveillance. This critical gap underscores the urgent need for novel therapeutic strategies. Nanomedicine has emerged as a promising approach, offering solutions for targeted drug delivery, precise imaging, and dynamic monitoring of AAA progression. This review comprehensively analyses recent advances in nanomaterial-based systems for AAA management. We classify and discuss key nanocarriers-inorganic nanomaterials, organic nanomaterials, and hybrid nanomaterials-highlighting their unique design strategies, targeting mechanisms, and therapeutic functions. Specific applications include the targeted delivery of anti-inflammatory agents, modulation of matrix metalloproteinase activity via siRNA delivery, protection of vascular smooth muscle cells (VSMCs) from oxidative stress and apoptosis, and strategies for in situ vascular repair and regeneration. Furthermore, the role of nanomaterials in enhanced diagnostics and intelligent sensing for rupture risk prediction is explored. Despite encouraging preclinical results, challenges regarding long-term biosafety, translatability from rodent models to human pathophysiology, and optimisation of hemodynamic delivery remain significant hurdles. Future directions involve closed-loop theranostic systems, artificial intelligence integration, hemodynamic-optimised nanoparticle design, and exploring gene-editing nanocarriers. This review concludes that engineered nanomaterials hold substantial potential to transform AAA management from passive monitoring to active prevention and precision therapy, paving the way for future clinical translation.