Top 10 candidate aortic disease trials.,Journal of Internal Medicine

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Top 10 candidate aortic disease trials.
Journal of Internal Medicine ( IF 9.0 ) Pub Date : 2020-03-18 , DOI: 10.1111/joim.13042
R L Dalman ₁ , A Wanhainen ₂ , K Mani ₂ , B Modarai ₃

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Aortic pathologies such as aneurysm, dissection and trauma are relatively common and potentially fatal diseases. Over the past two decades, we have experienced unprecedented technical and medical developments in the field. Despite this, there is a great need, and great opportunities, to further explore the area. In this review, we have identified important areas that need to be further studied and selected priority aortic disease trials. There is a pressing need to update the AAA natural history and the role for endovascular AAA repair as well as to define biomarkers and genetic risk factors as well as influence of gender for development and progression of aortic disease. A key limitation of contemporary treatment strategies of AAA is the lack of therapy directed at small AAA, to prevent AAA expansion and need for surgical repair, as well as to reduce the risk for aortic rupture. Currently, the most promising potential drug candidate to slow AAA growth is metformin, and RCTs to verify or reject this hypothesis are warranted. In addition, the role of endovascular treatment for ascending pathologies and for uncomplicated type B aortic dissection needs to be clarified.

中文翻译：

前10名主动脉疾病候选试验。

主动脉病变，如动脉瘤，解剖和外伤是相对常见的并可能致命的疾病。在过去的二十年中，我们在该领域经历了前所未有的技术和医学发展。尽管如此，仍然有很大的需求和巨大的机会来进一步探索该地区。在这篇综述中，我们确定了需要进一步研究的重要领域，并选择了优先主动脉疾病试验。迫切需要更新AAA的自然历史和血管内AAA修复的作用，以及定义生物标志物和遗传危险因素以及性别对主动脉疾病发展和进展的影响。当代AAA治疗策略的主要局限性在于缺乏针对小型AAA的治疗方法，以防止AAA扩大以及需要进行手术修复，以及减少主动脉破裂的风险。目前，最有希望的可能减缓AAA生长的潜在药物候选药物是二甲双胍，因此有必要证实或拒绝采用该假设的RCT。此外，需要阐明血管内治疗在病理学上的进展以及对于单纯性B型主动脉夹层的作用。

更新日期：2020-03-18

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