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The mechanism by which aortic aneurysms first emerge and then grow is complicated and not fully understood.
It involves the weakening of the blood vessel wall due to an inflammatory process with multiple causes including genetic and immunological reasons.
The association with smoking, high blood pressure and high cholesterol (dyslipidaemia) means that atherosclerosis probably also forms part of the process.
Less frequently, aortic aneurysms can also arise secondary to weakening of the vessel wall, but due to a very specific cause such as an infection, certain blood vessel problems (e.g., vasculitis, dissections) or trauma.
Weakening of the aortic wall means that a section of the artery is unable to bear the pressure of the blood it transports. This results in its dilatation and the subsequent growth of an aneurysm which may eventually cause the aorta to rupture (burst). Nevertheless, it is important to highlight that this growth is usually very slow, occurring progressively over several years, so in most cases effective treatment can be implemented before it bursts.
The risk factors for developing an aortic aneurysm are:
Old age and male. Aortic aneurysms are much more commonplace in men than women and in patients over 60 years old.
Smoking. This is considered to be the most important modifiable risk factor. Smokers are 15 times more likely to suffer an aneurysm than non-smokers.
High blood pressure. This doubles the risk of having an aortic aneurysm. It also increases the rate at which aneurysms grow and therefore their risk of bursting.
Peripheral artery disease or lower extremity circulatory disorder. Pain in the legs when walking or resting, as well as ulcerations due to a lack of blood supply.
Caucasian. People with a Caucasian ethnic background have a higher risk of aortic aneurysms.
Genetic disorders. For instance, individuals with Marfan, Ehlers–Danlos, Loeys–Dietz or Turner syndrome. An increased risk has also been reported in patients with a family history of aneurysmal diseases even if they do not have a specific genetic disorder.
Inflammatory diseases of the blood vessels(vasculitis). Such as giant cell arteritis and Takayasu’s arteritis.
Aortic valve abnormalities. For example, those affecting the bicuspid aortic valve in thoracic aortic aneurysms.
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Substantiated information by:
Eduardo Quintana ObradorVascular SurgeonCardiovascular Surgery Department
Xavier YuguerosVascular SurgeonAngiology and Vascular Surgery Service
Published: 10 March 2020
Updated: 10 March 2020
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