If the patient does not note any pathological symptoms, has a low level of risk (less than 5% according to SCORE), and the total cholesterol value exceeds 5 mmol / liter, then the treatment involves only lifestyle correction:
- exclusion of smoking and other bad habits;
- changing the diet;
- compliance with physical activity.
After normalizing the level of total cholesterol to 5 mmol / liter, and LDL to 3 mmol / liter, a regular preventive examination is prescribed every 3-5 years.
Patients with a high SCORE risk and total cholesterol of more than 5 mmol / liter should also change their lifestyle with laboratory follow-up at 3 months. If after the specified period the situation stabilizes, then further preventive diagnostics are prescribed annually. In case of instability of indicators or in the presence of typical symptoms of atherosclerosis, conservative treatment is prescribed.
Drugs that eliminate hyperlipidemia are represented by several classes of drugs: statins (drugs that inhibit HMG-CoA reductase), Ezetimibe, sequestrants (drugs that bile bile acids), fibrates, nicotinic acid drugs, polyunsaturated fatty acids, lipase inhibitors. 
- Statins are drugs that inhibit HMG-CoA reductase: Lovastatin, Simvastatin, Atorvastatin, Pravastatin, Fluvastatin, Rosuvastatin.
- Preparations inhibitors of cholesterol absorption in the intestine: Ezetemib is an active hypocholesterolemic agent.
- Bile acid sequestrants are drugs that enhance the excretion of bile acids from the body - the basic product of cholesterol metabolism (Cholestyramine, Colestipol).
- Funds derived from fibric acid - fibrates - are represented by Gemfibrozil, Bezafibrate, Ciprofibrat, Fenofibrat, Clofibrate.
- Nicotinic acid preparations - niacin - have cholesterol-lowering properties, reduce the content of lipoprotein.
- Omega-3 polyunsaturated fatty acids in sufficiently large dosages (up to 4 g per day) eliminate hypertriglyceridemia.
With atherosclerosis of the abdominal aorta, combination therapy is appropriate, which allows you to stop the development of the pathological process and prevent the occurrence of complications.
Conservative treatment most often consists in the use of such medicines:
- Anticoagulants - for example, Heparin at an initial dosage of 5 thousand units injectable under the control of blood clotting, or Enoxaparin sodium 20-40 mg per day in the form of subcutaneous injections, or Nadroparin calcium 0.2-0.6 ml in the form of subcutaneous injections 1 -2 times a day (depending on the patient's weight).
- Antiplatelet agents - for example, acetylsalicylic acid in the amount of 75-325 mg daily by mouth, or Clopidogrel at 75-300 mg daily by mouth, or Dipyridamole at 50-600 mg per day by mouth. Patients should take such drugs for a long time (sometimes for life), under regular laboratory supervision. Chaotic intake of drugs in large doses can lead to hemorrhagic complications, the appearance of signs of heart failure.
- To eliminate pain, appoint:
- non-steroidal anti-inflammatory drugs, if there are no contraindications (Ketorol, Ibuprofen), paravertebral blockade;
- opioids (Morphine, Fentanyl) - in severe cases, if non-steroidal anti-inflammatory drugs do not help.
- Drugs that normalize microcirculation and improve the condition of blood vessels (angioprotectors):
- Pentoxifylline 100-300 mg by injection;
- Alprostadil 20-60 mcg injected daily.
Possible side effects when taking angioprotectors can be allergic reactions, abdominal pain, and digestive disorders. 
- Anticholesterol-lowering drugs are taken for several months (usually up to a year, depending on blood cholesterol levels). Simvastatin and Atorvastatin are usually prescribed internally. Side effects in the form of allergies, myopathy, dyspeptic symptoms are rare.
- Drugs for pathogenetic treatment are often represented by β-blockers - Propranolol, Bisoprolol, Metaprolol. The dosage is standard, therapy is carried out under regular monitoring of heart rate and blood pressure indicators. Cancellation of these drugs is performed gradually.
Diet for atherosclerosis of the abdominal aorta
Diet correction is an effective way to stop the development of atherosclerosis. And this method is in no way inferior to drug therapy, and often even surpasses it. Many doctors point out that one should not rely only on drugs: without changes in diet, one cannot count on a stable and long-term effect of treatment.
As a rule, patients with atherosclerosis of the abdominal aorta are prescribed dietary table No. 10 - the appropriate dietary food normalizes blood cholesterol and inhibits the progression of the disease. In addition, the diet includes a large amount of plant foods rich in dietary fiber and polyunsaturated fatty acids, which help to increase the amount of "good" cholesterol.
In addition to following a diet, it is important to track food calories. With little physical activity, you should not consume more than 2500 calories per day. And for overweight patients, the doctor will help to choose the daily calorie content.
With atherosclerosis, animals and hydrogenated fats, which increase the level of cholesterol and its deposition on the vascular walls, are prohibited. It is important to exclude such foods from the diet:
- fatty meat, lard;
- butter, margarine, vegetable and fat mixtures, lard;
- offal (including liver);
- broths on meat or bones;
- sausages, sausages, wieners;
- any parts of the poultry, except for skinless fillets;
- milk, hard cheese, fat cottage cheese, cream, condensed milk, sour cream, ice cream;
- fast food;
- sugar, baked goods, pastries.
You should also limit the use of alcohol, and it is better to exclude it altogether.
The diet should contain the following foods:
- peeled chicken, turkey fillet;
- dairy veal;
- fish, seafood;
- fermented milk products (low-fat cottage cheese, kefir, yoghurts without additives);
- eggs (no more than 2 per week);
- any vegetables, fruits, herbs, berries;
- durum wheat pasta;
- cereals (buckwheat, rice, barley, wheat, oatmeal, bulgur, couscous);
- legumes (beans, chickpeas, mung bean, lentils, peas);
- dark bread, bran;
- herbal teas, green tea, dried fruit compotes, fruit drinks;
- dried fruits.
In no case should you neglect nutritional correction. Diet plays a fundamental role in the treatment of atherosclerosis, and also serves to prevent the development of complications - in particular, myocardial infarction and other cardiovascular pathologies. 
Physiotherapy is an effective treatment using natural and physical factors. These are thermal influences, ultrasonic influences, magnetic fields, laser, water, therapeutic mud, massage, etc. The methods are usually simple and at the same time extremely effective: with a minimum of side effects, an intense positive effect is noted, which makes it possible to reduce the dosage of the medications used. A particularly pronounced effect is noted if physiotherapy is used in the early stages of the development of pathology.
In atherosclerosis of the abdominal aorta, the following types of physiotherapy are considered the most common:
- Electrophoresis with novocaine, as well as vasodilators, antiplatelet, anti-inflammatory drugs, anti-inflammatory drugs. Potassium iodide, sodium salicylate, heparin, lithium, zinc, multivitamins, magnesium sulfate, nicotinic acid, mezaton, etc. Are often used.
- Darsonvalization has a pronounced antispastic effect on the vascular wall, as a result of which it relieves spasm and improves blood flow. The action is explained by the irritation of nerve receptors by impulse currents.
- Hyperbaric oxygenation is a high pressure oxygenation technique. For the procedure, special hyperbaric pressure chambers are used.
Spa treatment includes balneotherapy and mud therapy. A pronounced positive effect is found after taking hydrogen sulfide, carbon dioxide, iodine-bromine, pearl, turpentine baths.
The application of natural mud is indicated for patients with stages 1-2 of atherosclerosis.
Atherosclerosis of the abdominal aorta in the early stages of development responds well to treatment with alternative means, subject to lifestyle correction and getting rid of bad habits.  The most common and effective herbal medicine recipes are:
- 1 tbsp. L. Buckwheat flowers are brewed in a thermos in 1 liter of boiling water, infused for an hour, filtered. Take 100 ml three times a day between meals.
- Peel 300 g of garlic, pour it into a container and pour 0.5 l of vodka. It is kept in a dark place for a month, after which it is filtered and taken daily, 20 drops with 100 ml of milk, between meals.
- Take 1 tbsp. L. Birch leaves, brew 300 ml of boiling water, leave to cool, filter. Take 100 ml three times a day for half an hour before meals.
- Pour 1 tbsp. L. Hawthorn color 300 ml of boiling water, insist until it cools, filtered. Take 100 ml three times a day half an hour before meals.
- Take 2 tbsp. L. Rose hips, poured into a thermos, pour 300 ml of boiling water. Insist for 15 minutes, filter. Take 100 ml three times a day 20-30 minutes before meals.
- Drink the juice of one lemon daily, with or after meals.
- Squeeze 200 ml of onion juice, mix with 200 ml of honey. Such a remedy is stored in the refrigerator and taken in 1 tbsp. L. Three times a day between meals, for 8-10 weeks.
- Prepare a collection of 10 g of lemon balm, 10 g of a drop cap, 40 g of hawthorn flowers, 30 g of strawberry leaves. Brew 1 st. L. Collecting 300 ml of boiling water, drink instead of tea during the day (you can add honey for taste).
- Take 100 g of fresh sage herb, pour 500 ml of vodka and insist for a month and a half in a dark place. Next, the tincture is filtered and taken in 1 tbsp. L. With water in the morning and before meals, only 3 times a day.
- Squeeze juice from fresh horseradish root. Mix in half with honey and take 1 tbsp. L. In the morning, one hour before the first meal. The duration of treatment is 1 month.
If conservative therapy turns out to be ineffective or inappropriate, the patient is prescribed invasive treatment - therapeutic apheresis - plasmapheresis and LDL apheresis. Surgical treatment may be required when there is a high threat or the development of arterial occlusion - a thrombus or plaque. If atherosclerosis affects the heart vessels and the risk of developing myocardial infarction increases, coronary artery bypass grafting is performed.
Cardiac surgery involves performing open interventions or minimally invasive endovascular surgeries. For example, to eliminate ischemic processes in the lower half of the body and to stabilize hemodynamics, a vascular stenting operation is prescribed. And with aortic aneurysm, prosthetics and endoprosthetics of the abdominal aorta are indicated. 
If the diametrical size of the pathological protrusion in the aneurysm is less than 50 mm, then the patient is given drug therapy aimed at normalizing cardiovascular activity with its regular monitoring. If the diameter of the aneurysm is equal to or greater than 50 mm, then surgical treatment is prescribed to prevent rupture of the aorta. Also, an indication for surgery can be a protrusion with a diameter of 30 mm, with an annual rapid increase in size by 6 mm.
Surgical treatment can be performed at any age, if the patient does not have the following contraindications:
- acute disorders of cerebral or coronary circulation with obvious neurological insufficiency;
- circulatory failure II-b or III stage.
Abdominal aorta surgery for atherosclerosis
Prosthetics of the abdominal aorta is performed with an open access (15-20 cm incision) or a mini-access in the form of an incision on the abdominal wall of about 5-7 cm. The surgeon processes the operating field, performs the necessary incisions, and compresses the abdominal aorta above and below the affected area. The aneurysm is excised and a previously prepared vascular implant is sewn in instead of the removed segment. After making sure that the seams are tight, the doctor installs drains and sutures the wound. The most common are vascular implants impregnated with silver: they are more resistant to infection. The intervention lasts about 3.5 hours, then the patient is transferred to the intensive care unit, where his condition is monitored throughout the day. The general term for hospital stay is about a week (assuming no complications). 
Aortic arthroplasty is considered a more modern surgical method. The damaged segment of the abdominal aorta is replaced with a special vascular prosthesis, which is placed directly in the aneurysm cavity under X-ray observation. This technique allows you to prevent a large number of complications, shorten the patient's stay in the hospital, and accelerate rehabilitation. Perhaps the only drawback of such an intervention is its high cost. 
Possible contraindications for surgical treatment:
- severe disorders of vital organs, such as acute hepatic or renal failure, cerebrovascular accident, myocardial infarction, etc.