Medical Management of Thoracic Aortic Aneurysms

Aneurysmal disease of the thoracic aorta is increasing in incidence due to greater use of advanced imaging. Thoracic aortic aneurysms are at risk of acute aortic syndromes, which can be life-threatening. The mainstay of management for the ascending aorta and aortic arch is surgical, while endovascular therapy has become first-line for the descending thoracic and abdominal aorta. Medical management in acute aortic syndromes serves as a temporizing measure, while in stable aortic aneurysms, it attempts to provide secondary prevention of further aneurysmal progression. In this review, we discuss the guidelines for medical management of thoracic aortic aneurysms, the data behind these recommendations, and the potential for future medical therapy targets.