Ways to Correct Indications for Surgical Treatment of Atherosclerotic Descending Aortic Aneurysms

Recent studies suggest that the development of atherosclerotic descending aortic aneurysms (DAA) is a complicated process, which occurs due to a polymorphic nature of aortic wall abnormalities. They overlap and contribute to a wide variety of clinical manifestations. The inflammatory process may be the main reason for a rapid growth and rupture of the aneurysm. It also involves a mechanism of complex adhesion comprising of acute-phase proteins to low-density lipoproteins (LDLPs) as atherosclerotic lesions. This process occurs in the presence of connective tissue disorders, aortic wall focal cystic medianecrosis, poor management of arterial hypertension, aging, and reduced compliance. Therefore, the surgical treatment modality to treat DAA becomes less appealing. Additionally, it is not feasible to make indications for surgery based solely on linear aneurysmal diameter. However, medical correction has no contraindications for use.