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Diffuse Extra-Thoracic Vascular Disease in Nonsyndromic Thoracic Aortic Aneurysm and Dissection
Luke Dreher1, Hussein Abdul Nabi1, Hend Bcharah1
1Department of Cardiovascular Medicine, Mayo Clinic Arizona, Phoenix, Arizona.
The American Journal of Cardiology
|February 27, 2026
Summary
Extra-thoracic aneurysms and dissections are common in nonsyndromic thoracic aortic aneurysm and dissection (nsTAAD) patients, increasing with age. This highlights the need for comprehensive vascular assessment and risk factor management in this population.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Radiology
Background:
- Nonsyndromic thoracic aortic aneurysm and dissection (nsTAAD) can involve systemic arteries, but extra-thoracic disease patterns are unclear.
- Understanding the prevalence and correlates of these conditions is crucial for comprehensive patient management.
Purpose of the Study:
- To determine the distribution and clinical associations of extra-thoracic aneurysms and dissections in adults with nsTAAD.
- To identify predictors of non-thoracic aneurysms (nTA-A) and non-aortic dissections (nTA-D) in this cohort.
Main Methods:
- Retrospective cohort study of 3,989 nsTAAD patients at Mayo Clinic (2018-2024).
- Manual confirmation of thoracic and extra-thoracic vascular lesions, excluding syndromic cases.
- Analysis of imaging data (head/neck, chest, abdomen/pelvis) and logistic regression for predictor identification.
Main Results:
- Extra-thoracic aneurysms (nTA-A) were detected in 13.5% of imaged patients, increasing with age (18.3% in ≥51 years).
- Extra-thoracic dissections (nTA-D) occurred in 3.4% of patients, also rising with age.
- Hypertension and hyperlipidemia were independently associated with nTA-A; nTA-A/nTA-D correlated with higher rates of heart failure, MI, stroke, and mortality.
Conclusions:
- Extra-thoracic aneurysms and dissections are prevalent in nsTAAD patients and are age-dependent.
- Findings support thorough clinical assessment, symptom monitoring, and risk factor optimization.
- This study provides a basis for future research on broader vascular evaluation for improved risk stratification in nsTAAD.
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