Aortenbogenpathologien: ätiologie, epidemiologie und natürlicher verlauf

The international data on pathologies in the aortic arch sector are very limited, particularly because the aortic arch is rarely affected on its own; more often it is part of a larger disease (ascending aneurysm, aortic dissection, transverse aortic arch). Pathoanatomically, diseases in the area around the aortic arch can be equated with those of the ascending aorta with changes to the wall (media degeneration). Atherosclerotic changes that often occur in the descending aorta are usually the exception to the rule. Relevant diseases that are usually accompanied by the development of aortic-arch- associated changes include Marfan syndrome, familial thoracic aorta syndrome, aortic dissection, and Takayasu's arteritis. With regard to the natural course of the disease, when taking the underlying disease into consideration, one must generally assume increased morbidity and mortality with an aortic diameter >6 cm. In reference to this data, concurrent with changes in the area around the ascending aorta and depending on the individual risk profile of the patient and the institutional rate of complications, the threshold value is an aortic diameter >5.5 cm.