Bautista-González S, Gúzman-Chávez OR, Sandoval-Virgen FG.

Idioma: Español
Referencias bibliográficas: 32
Paginas: 204-210
Archivo PDF: 542.30 Kb.

RESUMEN

Un aneurisma es una dilatación patológica en un segmento de un vaso sanguíneo que puede romperse por adelgazamiento de la pared vascular. Un aneurisma aórtico abdominal (AAA) ocurre cuando una porción de la aorta por debajo de las arterias renales se expande a un diámetro igual o mayor a 3 cm. Es la décima causa de muerte en caucásicos mayores de 60 años. Tiene una prevalencia del 4-7% y una tasa de mortalidad de 30-60%. El tabaquismo aumenta hasta cinco veces el riesgo de padecer AAA.
Su patogénesis es multifactorial. Histológicamente se observa un patrón inflamatorio con destrucción de la colágena y elastina de las capas media y adventicia de la arteria, con infiltración de linfocitos y macrófagos, así como neovascularización. La mayoría de los AAA son asintomáticos y son encontrados de manera incidental. A medida que aumenta de tamaño puede desencadenar dolor abdominal y/o lumbalgia aunado a la aparición de una masa palpable o soplos. Actualmente el ultrasonograma (USG) abdominal es el estándar de oro para su diagnóstico. El tratamiento médico es considerado en pacientes asintomáticos con aneurismas entre 4 a 5.5 cm. Se recomienda someter a cirugía a pacientes que presenten un aneurisma sintomático con diámetros menores, aneurisma mayor a 5.5cm o que aumente más de 0.5cm en 6 meses.

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