An aortic arch aneurysm is a less common form of thoracic aortic aneurysm and may account for around 10% of such aneurysms.
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Epidemiology
There is a recognized male predilection with most patient's presenting around to 6th to 7th decades of life.
Clinical presentation
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.
Pathology
As with other thoracic aneurysms, atherosclerosis still remains the 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