![]() ![]() The first manifestation of an aortic aneurysm may be a thromboembolic incident, such as stroke, lower limb ischemia, intestinal ischemia, renal infarction, or blue toe syndrome (acute ischemia of the toes caused by small emboli originating from the aneurysm cavity ).ġ. The majority of aortic aneurysms, regardless of location, are asymptomatic and most commonly identified as an incidental finding on imaging. It does not correspond to acute medical emergency of aortic dissection or aneurysm rupture (see Complications, below). What follows below pertains to an aneurysm that is either asymptomatic or causing symptoms related to the space it occupies. Normal aortic dimensions in adults: Table 3.19-1.ġ) Based on etiology: Atherosclerotic aneurysm (most common by far), degenerative aneurysm (Marfan syndrome, Ehlers-Danlos syndrome type IV, cystic degeneration of the aorta), postinflammatory aneurysm (Takayasu disease, giant cell arteritis, inflammation in the course of systemic diseases, syphilis, infective endocarditis, sepsis), posttraumatic aneurysm.Ģ) Based on shape: Fusiform aneurysm (much more frequent), saccular aneurysm ( Figure 3.19-2).ģ) Based on wall structure: True aneurysm, pseudoaneurysm (or “false aneurysm” after disruption of the intima and media, the aneurysm wall is formed by the adventitia together with surrounding tissues this type is often posttraumatic Figure 3.19-2).Ĥ) Based on location: Thoracic aneurysm (usually of the ascending aorta but also can be seen in the aortic arch or descending thoracic aorta), abdominal aneurysm (located below the diaphragm infrarenal aneurysms constitute ~90% of aortic aneurysms), thoracoabdominal aneurysm (more extensive, involving both the thoracic and abdominal aorta).ĥ) Based on clinical presentation: Asymptomatic, symptomatic, dissecting ( Figure 3.19-2), ruptured.Ĭlinical Features and Natural History Top PMID: 25173340.Īortic aneurysm is a local dilation of the aorta by >50% of its normal diameter. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. PMID: 29268916.Įrbel R, Aboyans V, Boileau C, et al ESC Committee for Practice Guidelines. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. ![]() Contemporary Management of Aortic Arch Aneurysm. Multidetector CT of Thoracic Aortic Aneurysms1. (2016) European Journal of Cardio-Thoracic Surgery. Aortic arch aneurysm: short- and mid-term results comparing open arch surgery and the hybrid procedure. Cazavet, Alexandre, Alacoque, Xavier, Marcheix, Bertrand, Chaufour, Xavier, Rousseau, Herve, Glock, Yves, Leobon, Bertrand. Syphilis: the arch may be involved in around 34% of syphilitic aortic aneurysms 6 Infectious as well as non-infectious inflammatory conditions of the aorta or forms of aortitis such as: PathologyĪs with other thoracic aneurysms, atherosclerosis still remains the commonest etiology.įamilial thoracic aortic aneurysm (TAA) syndromeĭeceleration injuries: have been reported to cause dilation of the segment just after the aortic arch (usually tends to represent pseudoaneurysms) ![]() It can be clinically silent and patients can present with complications such as cerebral injury and/or a catastrophic vascular event especially if it involves vessels supplying to the head, neck, and upper limbs. There is a recognized male predilection with most patients presenting around the 6 th to 7 th decades of life. ![]()
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