cardiovascular disorders
Thoracic Aortic Aneurysms
Key Points
Thoracic aortic aneurysm (TAA) is a ≥ 50% increase in diameter of the thoracic aorta. TAAs may dissect, compress, or erode into adjacent structures, cause thromboembolism, leak, or rupture. Median diameter at aneurysm rupture is 6 cm for ascending aneurysms and 7 cm for descending aneurysms. Diagnosis is often first suspected based on an incidental x-ray or CT finding, and confirmed using CT angiography, magnetic resonance angiography, or transthoracic echocardiography. Treat small, asymptomatic TAAs with aggressive management of blood pressure and dyslipidemia and smoking cessation. Treat larger or symptomatic TAAs with endovascular stent grafting when anatomically possible and open surgical repair for more complex aneurysms. 