What is an aortic aneurysm?
An aortic aneurysm is an abnormal bulging or dilation of the aorta, the largest artery in the body. It can occur in the chest (thoracic aortic aneurysm) or abdomen (abdominal aortic aneurysm). Aneurysms are dangerous because they can rupture, causing life-threatening internal bleeding. Surgery is typically recommended when the ascending aorta reaches 5.5 cm (or 5.0 cm with risk factors like Marfan syndrome, bicuspid aortic valve, or family history).
The complete answer.
Thoracic aortic aneurysms are often discovered incidentally on imaging performed for other reasons. They grow slowly — typically 1-2 mm per year — and are monitored with serial CT or MRI. Surgical options include open replacement (the gold standard for ascending aorta) and TEVAR (endovascular stent graft, used for descending aorta). Connective tissue disorders like Marfan syndrome and Loeys-Dietz syndrome require earlier intervention at smaller sizes. Family screening is recommended when an aneurysm is identified, as there is a strong genetic component.
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