[Atherosclerotic and dissecting aortic aneurysms]

Atherosclerotic aortic aneurysm frequently contains organized thrombus on its luminal surface. Macroemboli or microemboli derived from fragile thrombus may cause occlusion of peripheral arteries. Although this ischemic symptom is seen preoperatively, it occurs more frequently as a complication caused by intraoperative manipulation. Of late, aortic dissection with clotted false lumen has been recognized as having unique characters with good prognosis. There is, however, no definite diagnostic criteria or treatment strategy for this entity. Disseminated intravascular coagulation is a rare consequence of massive thrombus formation in giant atherosclerotic or dissecting aortic aneurysm. In this chapter, we will describe clinical signs relevant to the thrombus formation in these aortic aneurysms, and refer to key points of surgical treatment.