Degenerative changes in the wall of the aorta lead to cystic medial necrosis. This causes damage to collagen and elastin, loss of smooth muscle cells and increased amounts of basophilic ground substance in the medial (elastic) layer of the aorta. The ascending TAA is usually more affected by cystic medial necrosis. Descending aortic aneurysm is a primary consequence of Atherosclerosis .
Compression of recurrent laryngeal nerve causing hoarseness of voice.
Vascular consequences include aortic regurgitations due to dilatation of aortic root,Thromboembolism causing stroke, lower extremity ischemia, renal infarctions, or mesenteric ischemia also can occur .
Long term Beta blocker therapy.And control of hypertension.
Operative repair with placement of prosthetic graft is indicated in patients with symptomatic thoracic aortic aneurysm and in patients with aortic diameter of >5.5 to6 cm or has increasing by>1cm per year .