Aortic arch aneurysm

An aortic arch aneurysm is a less common form of thoracic aortic aneurysm and may account for around 10% of such aneurysms.

Epidemiology

There is a recognized male predilection with most patient's presenting around to 6^th to 7^th decades of life.

Clinical presentation

It can be clinically silent and can complicated by cerebral injury and / or a catastrophic vascular event especially if it involves vessels supplying to the head, neck, and upper limbs.

Pathology

As with other thoracic aneurysms, atherosclerosis still remains commonest etiology. 

Other associations include

• Marfan syndrome
• Loeys-Dietz syndrome
• Ehlers-Danlos syndrome
• Turner syndrome
• familial TAA syndrome
• Behcet disease
• deceleration injuries: have been reported to cause dilation of the segment just after the aortic arch (usually tends to represent pseudoaneurysms)
• infectious as well as non-infectious inflammatory conditions of the aorta or forms of aortitis such as
  • syphilis: the arch may be involved in around 34% of syphilitic aortic aneurysms ⁶
  • giant cell arteritis
  • Takayasu arteritis