At the 65th Vascular Annual Meeting of the Society for Vascular Surgery®, Gilbert R. Upchurch, Jr., MD from the division of thoracic and cardiovascular surgery at University of Virginia Health System in Charlottesville, spoke about gender differences in abdominal aortic aneurysms (AAA's).
"Abdominal aortic aneurysms comprise the 10th leading cause of death in Caucasian males 65-74 years of age and accounted for nearly 16,000 deaths in the year 2000," said Dr Upchurch. "Therefore, understanding the pathophysiology of AAA's is an important undertaking."
Dr. Upchurch reported that even though male gender is a well-established risk factor for the development of an AAA with a 4:1 male to female ratio however the reason for this gender disparity is unknown.
"Clinically, multiple risk factors are associated with the development of AAA's, including increasing age, positive smoking history and hypertension," said Dr. Upchurch. "The pathogenesis of AAA's formation is complex and multi-factorial. Histologically, AAA's are characterized by early chemokine driven leukocyte infiltration into the aortic wall. Subsequent destruction of elastin and collagen in the media and adventitia ensues due to excessive local production of matrix degrading enzymes, and is accompanied by smooth muscle cell loss and thinning of the aortic wall."
Presently there are no medical therapies available to treat patients with aortic aneurysms, using only the crude measurement of aortic diameter as a threshold for which patients must undergo life-threatening and costly surgery, added Dr. Upchurch. "Defining the early mechanisms underlying gender-related differences in AAA formation are critical, as understanding differences in disease patterns based on gender may allow us to develop new translational approaches to the prevention and treatment of patients with aortic aneurysms."
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