Aneurysmal Disease

Abdominal aortic aneurysm (AAA), thoracic aortic aneurysm (TAA), and peripheral aneurysms (popliteal, visceral) develop due to degeneration of vascular wall connective tissue. Smoking is the most consistent modifiable risk factor for AAA, conferring a 5-fold increased risk [@sakalihasan2018]. Recent epidemiological data highlight the continued global burden of aortic disease, with significant variations in prevalence based on age and sex [@martin2025], [@esvs2023]. Beyond clinical outcomes, there is an increasing recognition of the impact of AAA on patient quality of life, necessitating the integration of patient-reported outcomes (PROs) into clinical assessment to address evolving dynamic patient needs [@smolderen2026], [@smolderen2026-evolving].[@smolderen2026-evolving], [@smolderen2026-c]. Familial clustering suggests genetic predisposition, and current guidelines emphasize the importance of genetic screening in patients with thoracic aortic disease [@aha2022-isselbacher], [@aha2022].[@aha2022], [@aha2022-c]. Systematic reviews supporting society guidelines, including those from the Society for Vascular Surgery (SVS), reinforce the need for specialized management and surveillance in heritable thoracic aortic disease (HTAD) to prevent catastrophic events [@firwana2023], [@firwana2023-systematic].[@firwana2023-systematic], [@firwana2023-c]. Connective tissue disorders such as Marfan, Loeys-Dietz, and Ehlers-Danlos syndromes are strongly associated with TAA and dissection [@rutherford2018], [@aha2022-isselbacher]. 

> **See Also:** [[Aneurysmal Diseases|Ch. 4: Aneurysmal Diseases]] for detailed management of AAA, TAA, and peripheral aneurysms.