This overview contains suggestions for two different types of trials, medical treatment of small aneurysms and methods for selection of aneurysms in need of intervention. Questions in need of answers are evaluation of the influence on growth and rupture by medical treatment and parameters other than absolute diameter for selection of patients for open surgical or endovascular intervention. These questions need not necessarily be answered by randomised controlled trials.
BergoeingMPThompsonRWCurciJA: Pharmacological targets in the treatment of abdominal aortic aneurysms. Expert Opin Ther Targets2006;10(4):547–559.
2.
GadowskiGRPilcherDBRicciMA: Abdominal aortic aneurysm expansion rate: Effect of size and beta-adrenergic blockade. J Vasc Surg1994;19(4):727–731.
3.
LeachSDTooleALSternHDenataleRWTilsonMD: Effect of beta-adrenergic blockade on the growth rate of abdominal aortic aneurysms. Arch Surg1988;123(5):606–609.
4.
Propranolol Aneurysm Trial Investigators: Propranolol for small abdominal aortic aneurysms: Results of a randomized trial. J Vasc Surg2002;35(1):72–79.
5.
LindholtJSHennebergEWJuulSFastingH: Impaired results of a randomised double blinded clinical trial of propranolol versus placebo on the expansion rate of small abdominal aortic aneurysms. Int Angiol1999;18(1):52–57.
6.
MooreGLiaoSCurciJAStarcherBCMartinRLHendricksRTChenJJThompsonRW: Suppression of experimental abdominal aortic aneurysms by systemic treatment with a hydroxamate-based matrix metalloproteinase inhibitor (RS 132908). J Vasc Surg1999;29(3):522–532.
7.
CurciJAPetrinecDLiaoSGolubLMThompsonRW: Pharmacologic suppression of experimental abdominal aortic aneurysms: A comparison of doxycycline and four chemically modified tetracyclines. J Vasc Surg1998;28(6):1082–1093.
8.
BaxterBTPearceWHWaltkeEALittooyFNHallettJWJrKentKCUpchurchGRJrChaikofELMillsJLFlecktenBLongoGMLeeJKThompsonRW: Prolonged administration of doxycycline in patients with small asymptomatic abdominal aortic aneurysms: Report of a prospective (Phase II) multicenter study. J Vasc Surg2002;36(1):1–12.
9.
MosorinMJuvonenJBiancariFSattaJSurcelHMLeinonenMSaikkuPJuvonenT: Use of doxycycline to decrease the growth rate of abdominal aortic aneurysms: A randomized, double-blind, placebo-controlled pilot study. J Vasc Surg2001;34(4):606–610.
10.
VammenSLindholtJSOstergaardLFastingHHennebergEW: Randomized double-blind controlled trial of roxithromycin for prevention of abdominal aortic aneurysm expansion. Br J Surg2001;88(8):1066–1072.
SteinmetzEFBuckleyCShamesMLEnnisTLVanvickle-ChavezSJMaoDGoeddelLAHawkinsCJThompsonRW: Treatment with simvastatin suppresses the development of experimental abdominal aortic aneurysms in normal and hypercholesterolemic mice. Ann Surg2005;241(1):92–101.
13.
SchoutenOvan LaanenJHBoersmaEVidakovicRFeringaHHDunkelgrünMBaxJJKoningJvan UrkHPoldermansD: Statins are associated with a reduced infrarenal abdominal aortic aneurysm growth. Eur J Vasc Endovasc Surg2006;32(1):21–26.
14.
SukhijaRAronowWSSandhuRKakarPBabuS: Mortality and size of abdominal aortic aneurysm at Longterm follow-up of patients not treated surgically and treated with and without statins. Am J Cardiol2006;97(2):279–280.
15.
EvansJPowellJTSchwalbeELoftusIMThompsonMM: Simvastatin attenuates the activity of matrix metalloprotease-9 in aneurysmal aortic tissue. Eur J Vasc Endovasc Surg2007;34(3):302–303.
16.
Heart Protection Study Collaborative Group: MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: A randomised placebo-controlled trial. Lancet2002;360(9326):7–22.
17.
BradyARFowkesFGThompsonSGPowellJT: Aortic aneurysm diameter and risk of cardiovascular mortality. Arterioscler Thromb Vasc Biol2001;21(7):1203–1207.
DaughertyAManningMWCassisLA: Angiotensin II promotes atherosclerotic lesions and aneurysms in apolipoprotein E-deficient mice. J Clin Invest2000;105(11):1605–1612.
20.
SaraffKBabamustaFCassisLADaughertyA: Aortic dissection precedes formation of aneurysms and atherosclerosis in angiotensin II-infused, apolipoprotein E-deficient mice. Arterioscler Thromb Vasc Biol2003;23(9):1621–1626.
21.
HackamDGThiruchelvamDRedelmeierDA: Angiotensin-converting enzyme inhibitors and aortic rupture: A population-based case-control study. Lancet2006;368(9536):659–665.
22.
The UK Small Aneurysm Trial Participants: Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet1998;352(9141):1649–1655.
23.
LederleFAWilsonSEJohnsonGRReinkeDBLittooyFNAcherCWBallardDJMessinaLMGordonILChuteEPKrupskiWCBusuttilSJBaroneGWSparksSGrahamLMRappJHMakarounMSMonetaGLCambriaRAMakhoulRGEtonDAnselHJFreischlagJABandykD; Aneurysm Detection and Management Veterans Affairs Cooperative Study Group: Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med2002;346(19):1437–1444.
24.
LanneTSandgrenTSonessonB: A dynamic view on the diameter of abdominal aortic aneurysms. Eur J Vasc Endovasc Surg1998;15(4):308–312.
25.
SonessonBLanneTHansenFSandgrenT: Infrarenal aortic diameter in the healthy person. Eur J Vasc Surg1994;8(1):89–95.
26.
BrownLCPowellJT: Risk factors for aneurysm rupture in patients kept under ultrasound surveillance. UK Small Aneurysm Trial Participants. Ann Surg1999;230(3): 289–96; discussion 96–97.
27.
FillingerMFRaghavanMLMarraSPCronenwettJLKennedyFE: In vivo analysis of mechanical wall stress and abdominal aortic aneurysm rupture risk. J Vasc Surg2002;36(3):589–597.
28.
FillingerMFMarraSPRaghavanMLKennedyFE: Prediction of rupture risk in abdominal aortic aneurysm during observation: Wall stress versus diameter. J Vasc Surg2003;37(4):724–732.
29.
VandeGeest JPWangDHWisniewskiSRMakarounMSVorpDA: Towards a noninvasive method for determination of patient-specific wall strength distribution in abdominal aortic aneurysms. Ann Biomed Eng2006;34(7):1098–1106.
30.
EVAR trial participants: Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): Randomised controlled trial. Lancet2005;365(9478):2179–2186.
31.
BlankensteijnJDDe JongSEPrinssenMvan der HamACButhJvan SterkenburgSMVerhagenHJBuskensEGrobbeeDE; Dutch Randomized Endovascular Aneurysm Management (DREAM) Trial Group: Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Eng J Med2005;352(23):2398–2405.
32.
EVAR trial participants: Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): Randomised controlled trial. Lancet2005;365(9478):2187–2192.
BrownLCGreenhalghRMHowellSPowellJTThompsonSG: Patient fitness and survival after abdominal aortic aneurysm repair in patients from the UK EVAR trials. Br J Surg2007;94(6): 709–716.