Diagnostic and therapeutic protocol for thoracic aortic aneurysms

Abstract

Thoracic aortic aneurysms have an incidence of 6-10/100,000 inhabitants. Its incidence is increasing due to the aging of the population and the increased performance of imaging tests. They are generally asymptomatic and their natural history tends towards the growth of the aneurysm. The larger the size, the greater the probability of rupture (with high mortality). Early diagnosis is difficult (since patients are generally asymptomatic) and is usually incidental (e.g. a CT for other reasons). Monitoring small aneurysms and scheduled surgical treatment are aimed at preventing the aneurysm from rupturing. Endovascular treatment, which is increasingly being perfected, is effective and safe by reducing morbidity and mortality compared to open surgical treatment, which is the choice for aneurysms of the descending thoracic aorta. This protocol is mainly focused on aneurysms of the descending thoracic aorta and thoraco-abdominal. Those that affect the ascending thoracic aorta and aortic arch are within the field of cardiac surgery.