Aneurysmal Disease

in Overview of Vascular Disease

Applied

Type

Modification

Confidence

90%

Created

Apr 19, 2026

Evidence

1 source

Rationale

The superseding ACC/AHA aortic disease guideline (AHA, PMID 36480976) replaces the stale aha 2022 isselbacher and aha 2022 citations for the two claims they supported in this section: genetic screening/multidisciplinary care recommendations and connective tissue disorder associations with TAA. The updated guideline explicitly addresses multidisciplinary team-based management and specialized aortic centers, making it the preferred citation for these claims. Isselbacher EM et al is retained as it may support distinct claims elsewhere in the chapter. No other content changes are warranted.

Evidence

AHA. ACC/AHA Aortic Disease Guidelines: What Was Simple Is Now Complex-Moving to Multidisciplinary Teams, Specialized Centers. J Am Coll Cardiol. 2022. PMID: 36480976. DOI: 10.1016/j.jacc.2022.11.007.
Verified source
PubMedDOI

Content Changes

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-b]. Familial clustering suggests genetic predisposition, and current guidelines emphasize the importance of genetic screening in patients with thoracic aortic diseasedisease, [@aha2022-isselbacher],including [@aha2022],the transition toward multidisciplinary teams and specialized aortic centers [@aha2026], [@aha2022-b]. 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-b]. Connective tissue disorders such as Marfan, Loeys-Dietz, and Ehlers-Danlos syndromes are strongly associated with TAA and dissection [@rutherford2018], [@aha2022-isselbacher]. 

[@aha2026].

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