Natural history of arteriosclerotic thoracic aortic aneurysms.

Out of 28 patients with arteriosclerotic aortic aneurysm seen between 1965 and 1975, 22 were not surgically repaired. Of these 22 patients, 9 subsequently died of rupture and 7 of unrelated cardiovascular disease, and 6 are living at the time of this study. Mean survival for the group is less than 3 years. All but 1 rupture occurred in aneurysms larger than 10 cm, and recent increase in size preceded rupture in all patients for whom serial roentgenograms were available. This study documents the high risk of rupture of arteriosclerotic aortic aneurysms of the descending thoracic aorta and suggests a more uniform use of surgical management depending on the patient's age and underlying state of health.