Vol. 9, Issue 2, Part C (2025)

Background: Abdominal aortic aneurysms (AAAs) are a major clinical concern because of their tendency to grow over time and the significant danger they pose if rupture occurs. Despite regular use of imaging in clinical practice, predicting which aneurysms will actually increase significantly in size or rupture remains a significant challenge.
Objective: This review set out to explore whether blood-based biomarkers could improve our ability to forecast AAA growth and rupture risk, in hopes of making risk assessment and management more precise for affected patients.
Methods: We systematically searched PubMed, EMBASE, and Scopus for original, peer-reviewed studies involving human participants, up to March 2024. To be included, studies had to investigate circulating biomarkers in relation to AAA progression. We collected available data on which biomarkers were investigated, their predictive accuracy and evaluated each study’s quality using the Newcastle-Ottawa Scale.
Results: In total, we identified 18 relevant studies. The biomarkers under investigation mainly fell into four groups: inflammatory markers (such as C-reactive protein, interleukin-6, and tumor necrosis factor-alpha), factors related to the extracellular matrix (like MMP-2, MMP-9, and TIMP-1), genetic factors (such as microRNAs and certain SNPs), and markers linked to coagulation (including D-dimer and fibrinogen) of these, CRP, MMP-9, and D-dimer appeared most frequently as potential predictors of aneurysm expansion or rupture across several studies.
Conclusion: Overall, CRP, MMP-9, and D-dimer shows strong predictive value as promising biomarkers that could help Vascular surgeons anticipate which AAAs are at greatest risk of rapid progression or rupture. Integrating these markers into regular patient monitoring could help tailor surveillance and intervention. Still larger prospective studies are needed before these biomarkers can be reliably used in routine clinical care.