Chapter 9: Thoracic, Thoracoabdominal and Suprarenal Aortic Aneurysms

The following sections are included:

• Aneurysm disease affects the thoracic aorta much less commonly than the infrarenal aorta.

• Most patients are asymptomatic, but may have chest, back or abdominal pain.

• Diagnosis is on computed tomography (CT) angiogram and the Crawford classification is used to describe the extent of the aneurysm.

• Intervention is recommended if the aneurysm is >6 cm (or 5 cm in the presence of a connective tissue disorder or a family history of rupture).

• Open surgery remains the standard treatment for complex suprarenal, thoracic and thoracoabdominal aneurysms.

• Specific complications include risks of paraplegia and renal and visceral ischaemia.

• Endovascular repair is suitable for descending thoracic aneurysms.