Classification

In principle, three forms of aortic aneurysm can be distinguished. 1. the aneurysm verum is also called a real aneurysm. It is a sack- or spindle-shaped over-expansion and sacculation of all three wall layers (the so-called intima, media and adventitia).

2. in the case of aneurysm dissecans there is only a tearing of the intima. The blood reaches the inner vessel wall through the tear and splits it (dissection, root hemorrhage). This creates a double lumen, which may extend from the aorta of the chest to the abdominal aorta.

This leads to an over-expansion of the outer vessel wall (adventitia), which can possibly push off the vessels that have come off. In this case, certain areas of the body are no longer supplied with blood (descending ischemia syndrome). The blood that gets between the layers can possibly re-enter the regular vessel through a window.

Aneurysm dissecans also offers the possibility of self-healing. However, this does not exclude the possibility of a later rupture and must be feared. 3 The aneurysm spurium is also called false aneurysm (aneurysm falsum).

A leak in the arterial wall allows blood to escape from the blood vessel and form a haematoma in front of it. After some time, a capsule of connective tissue forms around the bleeding, which then emerges as a bulge. Since this is not a vascular wall, as is the case with other aneurysms, it is also called a false aneurysm.

Aneurysm verum,
Aneurysm dissecans and the
Aneurysm spurium. In addition to this classification, aortic aneurysms are also classified according to their height localization at the aorta. The aorta, the artery that runs from the heart and passes through the aortic arch into the abdominal aorta, is divided into 5 segments.

According to the division of DeBakey, a type 1 aortic aneurysm can affect the entire aorta. Aortic aneurysm type 2 is restricted to the ascending aorta only. A type 3 aortic aneurysm affects the area below the left subclavian.

A further division of the aortic aneurysm can be made according to Stanford. Only two groups are distinguished here. While type A is located at the aortic arch and the ascending aorta, type B is located at the descending aorta behind the outlet of the subclavian artery.

Finally, the aneurysms can also be classified according to their shape. The sacciform aneurysm is more sack-shaped, the fusiform aneurysm more spindle-shaped and the saccifusiform aneurysm is mixed. A boat-shaped form would be called a cuneiform aneurysm and a serpentine form consisting of different aneurysms (aneurysmosis) would be called a serpentinum aneurysm. Some of the potential complications may include aortic dissection, a tear in the inner wall of the aorta. This is accompanied by sudden sharp pain of the highest intensity.