THORACIC AORTIC-ANEURYSMS - A POPULATION-BASED STUDY

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  • 1 January 1982
    • journal article
    • research article
    • Vol. 92  (6) , 1103-1108
Abstract
Thoracic aortic aneurysms were detected in 72 residents (44 women, 28 men) in a stable Midwestern [USA] community over a 30-yr period, for an age- and sex-adjusted incidence of 5.9 new aneurysms/100,000 person-yr. The incidence was equal in both sexes and decreased slightly over 30 yr. Ages ranged from 47-93 yr (median 65 yr for men and 77 yr for women). The ascending aorta was involved in 37 patients, the aortic arch in 8 and the descending aorta in 27. Pathologic examination was performed in 51 patients. The cause was aortic dissection in 27 patients (53%), atherosclerosis in 15 (29%), aortitis in 4 (8%), cystic medial necrosis in 3 (6%) and syphilis in 2 (4%). All autopsied patients had pathologic evidence of significant hypertension. Eleven patients (25%) had concomitant abdominal aortic aneurysms. Rupture occurred in 53 patients (74%) and 50 died; 37 of these patients had no prior diagnosis of aneurysm. The median interval between diagnosis and rupture in the 16 remaining patients was 2 yr (range 1 mo. to 16 yr); 95% of aortic dissections ruptured and 51% of nondissecting aneurysms ruptured. The actuarial 5-yr survival for all 72 patients was 13%; for patients with aortic dissection, 7%; and for patients without dissection, 19.2%.

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