Aortic aneurysm natural history, complications and prognosis
Overview
If left untreated, 80% of patients with aortic aneurysms may progress to rupture or dissection.
Natural History, Complications and Prognosis
Even though the majority of the aortic aneurysms remain asymptomatic for years, their natural history is dissection or rupture.[1] According to Laplace's law, as the aneurysms grow larger they have a higher rate of expansion. Due to that, the frequency of monitoring changes with the diameter of the abdominal aortic aneurysm, being every 3 years for aneurysms with a 3-3.4cm diameter, yearly for diameters of 3.5-4.4cm, and every 6 months for larger than 4.5cm.[2] For the thoracic one, up to 80% of the aneurysms will eventually rupture, and patients present with a 10-20% five-year survival rate if they remain untreated.[1] Risk of rupture doubles every 1cm in growth over the 5cm diameter in descending thoracic aorta.[3]
Besides rupturing and dissection of the aorta, aortic aneurysms can also present with systemic embolization and aortic regurgitation (if the thoracic aortic aneurysm is located in the ascending aorta). The altered blood flow in the aneurysm can also lead to the formation of blood cloths and embolization. [4]
References
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- ↑ Juvonen T, Ergin MA, Galla JD, et al. Prospective study of the natural history of thoracic aortic aneurysms. Ann Thorac Surg 1997;63:1533-45
- ↑ Aortic Aneurysm: Symptoms and Complications - VeryWell Health available at: https://www.verywellhealth.com/aortic-aneurysm-symptoms-and-complications-4160769