Thoracic aortic aneurysm epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Amjad AlMahameed, MD, MPH, RPVI, FACP. Beth Israel Deaconess Medical Center and Harvard Medical School. Boston, USA Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]

Overview

Aortic aneurysm is one of the 15 top causes of death in most series.

Epidemiology and Demographics

• TAAs are relatively uncommon with an estimated incidence between 6 and 10 new aneurysms per 100,000 person-years. According to a study by Beckerstaff et al., the incidence of thoracic aortic aneurysms was reported to be 5.3 per 100,000 per year. Another study done by Clouse et al. showed the incidence to be 10.4 per 100,000 per year .
• However, the incidence and prevalence of TAD has been increasing in the past years. The annual number of surgeries performed on the aorta have increased, along with improved post- surgical and long term survival .

Age

• • TAAs are usually diagnosed after the sixth and seventh decade of life.
  • They typically expand slowly (approximately 0.1-0.2 cm/year). The risk of rupture is closely related to aneurysm size (3% for TAAs <4 cm and 7% for >6 cm).

Sex

• • Males are affected approximately two to four times more commonly than women.

• These bioepidemiological characteristics support the current stand that screening for TAA is not recommended in the general population. Certain population substrates, such as those with history of Marfan's syndrome, Turner's syndrome, Ehlers-Danlos type IV syndrome, familial thoracic aortic disease syndromes, and patients with bicuspid aortic valve should have imaging study to screen for TAAs.
• The widespread use of imaging techniques partly contribute to increased detection of thoracic aortic aneurysm in the elderly, consequently increasing its prevalence.