Aneurysms involving the aortic arch constitute a minor proportion of TAAs, accounting for about 10% of the total cases of thoracic aorta aneurysms. Thoracic aortic aneurysms (TAAs) have an estimated incidence of around 10 cases per 100 000 person-years. The true incidence and prevalence of aortic aneurysms are difficult to determine as most of them are often asymptomatic, with a large number of cases being diagnosed incidentally. Īlong with the risk factors for atherosclerosis such as smoking, hypertension, and hypercholesterolemia, factors that increase aortic wall stress, including pheochromocytoma, cocaine use, coarctation, weight lifting, also increase the likelihood for development of TAA. These include syphilis, giant cell arteritis, and Takayasu arteritis. īoth infectious as well as non-infectious inflammatory conditions of the aorta, or aortitis can also result in TAA. Deceleration injuries have been seen to cause dilation of the segment just after the aortic arch. The causes include Marfan syndrome, Loeys–Dietz syndrome, Ehlers– Danlos syndrome, Turner syndrome, familial TAA syndrome, and Behcet disease. The aneurysms found in relation to ascending thoracic aorta often result from cystic medial degeneration. Ītherosclerosis or plaque build-up is the predominant etiology for an isolated aneurysm of the aortic arch as well as for those associated with descending aorta. Left subclavian artery: It is the most distal branch and distributes blood to the left arm.Left common carotid artery: It carries blood to the left side of the head and neck.Brachiocephalic trunk (innominate artery): It further divides into the right subclavian and right common carotid arteries and supplies blood to the right arm and right head and neck.The upward convexity of the aortic arch stems out the following three main branches: The distal portion of the aortic arch lies to the left of the trachea, transverses downwards, and terminates adjacent to the lower border of T4, where it continues as the descending aorta. It represents the continuation of the ascending thoracic aorta, which begins at the level of the upper border of the second sternocostal joint of the right side courses posteriorly, superiorly, and to the left. The aortic arch is derived from the left branch of the fourth pharyngeal arch during embryonic development. Aortic arch aneurysms include any thoracic aneurysm that involves the brachiocephalic vessels. Ī true aneurysm is defined as a pathological dilation of a segment of a blood vessel involving all three layers of the vessel wall (tunica intima, media, and adventitia) and having at least a 50% increase in diameter compared with the expected normal diameter of the artery.
Aneurysms of the aortic arch are commonly found in association with aneurysms of the adjacent ascending or descending aorta. The true incidence and natural course are still relatively unknown however, aneurysms involving the arch pose a significant challenge pertaining to surgical management and can be complicated by neurological injury and life-threatening cardiovascular events. Review the management options available for the aortic arch aneurysm and the role of the interprofessional team in managing patients suffering from aortic arch aneurysms.Īn isolated aortic arch aneurysm is an uncommon disease entity and often remains clinically silent, given its indolent growth pattern.Outline the evaluation of a patient with the aortic arch aneurysm.Describe the pathophysiology of the aortic arch aneurysm.Identify the etiology of the aortic arch aneurysm.This activity describes the etiology, epidemiology, pathophysiology, and presentation of a patient with aortic arch aneurysm and reviews the evaluation and available treatment options and also highlights the role of the interprofessional team in evaluating and treating patients with this condition. To avoid the high morbidity and mortality associated with the life-threatening complications of this condition, it must be promptly diagnosed, monitored, and treated timely. Found in association with atherosclerosis, aneurysm of the aortic arch often remains clinically silent and is complicated by cerebral injury and catastrophic vascular events. An isolated aortic arch aneurysm represents the less frequent cause of thoracic aortic aneurysms but poses a significant surgical challenge as it involves the vessels supplying to the head, neck, and upper limbs.
0 kommentar(er)
