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

Aortic arch aneurysms have a recognized male predilection, with most patients presenting around the 6^th to 7^th 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 remains the commonest etiology. 

Other associations include:

• Marfan syndrome

• Loeys-Dietz syndrome

• Ehlers-Danlos syndrome

• Turner syndrome

• familial thoracic aortic aneurysm (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

See also

• aortic arch anatomy