Aortic aneurysm, genes (also) count

It is a silent enemy, which often develops without creating particular disturbances. The wall of the abdominal aorta gives way, swells, under the pressure of the pressure and breaks. Like a submarine, it acts “underwater” and then launches a life-threatening torpedo. Similarly, the aneurysm acts silently and is almost always asymptomatic. And unfortunately it turns out when it “breaks” creating a very serious situation burdened with high mortality. This is why it is essential to identify the lesion early and be able to intervene. But above all it is necessary to define that it is more at risk, since DNA could also play a role in predisposing to the development of arterial lesion, thanks to research that analyzes the genetic habitus in patients with aneurysms and healthy people. The hypothesis is re-launched by a study from the University of Michigan, coordinated by Katherine Gallagher. The scientists, in particular, focused attention on a gene called JMDJD3, which is activated both in experimental animals and in subjects with abdominal aortic aneurysms, suggesting its potential role as a risk element. the gene, in practice, would act as a promoter of inflammation, even in the arterial wall, predisposing to the onset of the lesion. In animals, by acting on the enzyme linked to the gene in question, it was possible to limit the formation of the aneurysm. In short: JMJD3 could become a target for the care of the future, aimed at reducing the risk of the abdominal aortic aneurysm forming and above all rupturing, with all that follows and that puts life itself at risk.

Pending the development of this research, at the moment, what matters most is to arrive early with the diagnosis. Because hurrying when fighting a time bomb is essential to prevent it from exploding. The abdominal aortic aneurysms behave like a timed device, perhaps to “explode due to an episode of high blood pressure. It is now possible to grasp these alterations in time: a simple ultrasound of the abdomen is enough to evaluate the diameter of the artery and to suggest the observation of the picture or the intervention over time, which can also be performed without the traditional scalpel but with probes inserted inside the circulatory tree. “According to the guidelines of the European Society for Vascular Surgery (Esvs), 5 cm in diameter is currently the limit of the observational management of atherosclerotic aneurysms of the abdominal abdominal subrenal aorta – explains Renato Casana, Head of the Vascular Surgery and Angiology Service and Director of the Experimental Research Laboratory of Vascular Surgery at the Italian Auxological Institute Irccs. This is therefore the diameter to refer to for the indication for surgical or endovascular treatment of the aneurysmal lesion. Small abdominal aortic aneurysms (between 4 and 5 centimeters) are indicated for treatment in case of: rapid growth of the aneurysmal lesion (greater than 5 millimeters per year), presence of blisters (i.e. bag-shaped dilation ) of the artery that increase the compliance of the aortic wall or symptomatic aneurysms in the pre-rupture phase. Endovascular treatment (by means of aortic endoprosthesis implantation with femoral access) currently represents the method of choice for the exclusion of the aneurysm if there are the clinical and anatomo-morphological requirements suitable for the implantation of an endoprosthesis “. The device is positioned, navigating inside the aneurysm, thanks to a delivery catheter that contains the prosthesis itself inside. Then the catheter is removed at the end of the surgery. “Alternatively, therefore, the surgical treatment requires the replacement of the aneurysm by reconstruction with aortic prosthesis, in what is called aortic endaneurysmectomy – concludes Casana”.