Fact-sheet: Aortic pseudoaneurysm
  • Subadventitial aortic rupture


Updated on 02/01/2024 at 1:58 PM

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Definition

Aortic pseudoaneurysm corresponds to a partial rupture of the arterial wall layers, forming an aneurysm contained by a surrounding collection:

- hematic in most cases due to iatrogenic or other trauma (anastomotic dehiscence, bypass, post-traumatic = subadventitial rupture)
- infectious (pseudoaneurysm resulting from infectious involvement of the aortic wall)
- penetrating atherosclerotic ulcer

Clinical features

Pulsatile, expansile mass.
Localized, severe pain.
+/- hemorrhagic shock

CT

Direct signs:

  • Visualization of the pseudoaneurysm
  • Irregular contour of the aortic wall
  • Intimal flap
  • Endoluminal mural thrombus

Indirect signs:

  • Mediastinal hematoma (not specific for aortic rupture, as it can result from rupture of the azygos vein/internal thoracic artery/intercostal artery)
  • Periaortic hematoma (not specific, as it can result from rupture of the vasa vasorum without aortic rupture)

Differential diagnosis

  • Inflammatory aneurysm
  • Pre-rupture aneurysm
  • Complete aortic rupture