Pathogenesis, Diagnosis, and Clinical Management of Aortic Aneurysms: Current Status and Future Perspectives

Aortic aneurysm (AA) is a life-threatening degenerative vascular disease defined as localized dilation of the aorta exceeding 1.5 times the normal diameter and isprimarily classified into abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA). With an aging population and increased exposure to risk factors, the incidence of AA is rising, and rupture is associated with a mortality rate of 80-90%. Recent advances in molecular biology, imaging, and interventional techniques have expanded the understanding of AA pathogenesis beyond the traditional "degenerative disease" model to encompass genetic variation, extracellular matrix (ECM) remodeling, inflammatory responses, and dysregulated signaling pathway. Meanwhile, diagnostic approaches have become increasingly precise, enabling earlier detection through routine screening and three-dimensional vascular reconstruction. Clinical management has evolved into a comprehensive strategy centered on surgical intervention, supported by pharmacological therapy and long-term monitoring. This review systematically examines the pathophysiological mechanisms, advancements in diagnostic technologies, and evidence-based clinical management of AA, discusses current controversies, and explores future applications of precision medicine.