From the Guidelines
Management of extensive atherosclerotic disease in the aorta should prioritize a multidisciplinary approach, including lifestyle modifications, medications, and close monitoring, as outlined in the 2024 ESC guidelines for the management of peripheral arterial and aortic diseases 1. The goal of treatment is to reduce morbidity and mortality by controlling cardiovascular risk factors (CVRF) and preventing disease progression.
- Key components of management include:
- Lifestyle modifications: smoking cessation, regular exercise, weight management, and a healthy diet low in saturated fats and sodium
- Medications: statins to lower LDL cholesterol, antiplatelet therapy with aspirin, and blood pressure control using ACE inhibitors or ARBs
- Close monitoring: regular follow-up with vascular imaging every 6-12 months to monitor disease progression In patients with acute aortic syndrome (AAS), prompt treatment with anti-impulse therapy and invasive monitoring of blood pressure is recommended, as outlined in the 2022 ACC/AHA guideline for the diagnosis and management of aortic disease 1.
- Initial management of AAS should include:
- Intravenous beta blockers to control heart rate and blood pressure
- Intravenous vasodilators if blood pressure is not well controlled
- Pain control as needed to help with hemodynamic management The use of web- or app-based calculators for estimation of CV risk may aid patient motivation for lifestyle changes and adherence to medication, as suggested by the 2024 ESC guidelines 1. Overall, a comprehensive approach to managing extensive atherosclerotic disease in the aorta is crucial to reducing the risk of serious complications and improving patient outcomes.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Management of Extensive Atherosclerotic Classification
The management of extensive atherosclerotic classification noted in the aortic involves a comprehensive approach, including:
- Guideline-directed medical therapy, such as structured physical activity and lifestyle modification, an antiplatelet agent, a statin, antihypertensive therapy, and smoking cessation counseling 2
- Surgical revascularization, which decreases adverse outcomes and mortality in selected patients with advanced vascular disease 2
- Endovascular repair, which has become more common for patients younger than 70 years due to decreased short-term mortality 2
- Carotid revascularization with carotid endarterectomy or carotid artery stenting, recommended for symptomatic patients with greater than 50% internal carotid artery stenosis 2
- Revascularization, a reasonable treatment option for patients with lifestyle-limiting claudication and an inadequate response to guideline-directed therapies 2
Medical Therapy
Medical therapy plays a crucial role in the management of atherosclerotic disease, including:
- Statin therapy, which has been associated with improved clinical outcomes in patients undergoing treatment for vascular disease 3
- Antiplatelet therapy, which is often used in combination with statin therapy to reduce the risk of adverse outcomes 3
- Lifestyle modification, such as smoking cessation, diet, and exercise, to reduce the risk of atherosclerotic disease progression 4
Emerging Innovations
Emerging innovations in the field of atherosclerotic disease management include:
- Nanomedicine, mRNA therapeutics, and gene editing, which have the potential to revolutionize CVD clinical practice by steering it toward precision medicine 5
- Novel therapeutics, which are in development and will add to the growing armamentarium available to physicians who manage atherosclerotic disease 4