Aortic Aneurysms

Definitions

  • True aneurysm (≥50% dilation of all 3 layers of aorta) vs. false (rupture within adventitia)
  • Location: root (annuloaortic ectasia), thoracic aortic aneurysm (TAA), thoracoabdominal aortic aneurysm (TAAA), abdominal aortic aneurysm (AAA)
  • Type: fusiform (circumferential dilation) vs. saccular (localized dilation of aortic wall)

Epidemiology (Circ 2010;121:e266, 2011;124:2020; Nat Rev Cardiol 2011;8:92)

  • TAA: ♂:♀ 2:1; ~60% root/ascending; 40% desc.
  • AAA: ~4–8% prev in those >60 y; 5× more common in ♂; mostly infrarenal

Pathophysiology & risk factors (NEJM 2009;361:1114; Nat Med 2009;15:649)

  • Medial degen and/or ↑ wall stress; wall stress Laplace’s law)