Thoracic aortic aneurysm — master index¶
Last curated: 2026-08-28 · 20 wiki pages (19 audited curated, 1 draft) · 344-paper master bibliography · 16 landmark-paper notes · 24-guideline registry · statistics sheet (~116 sourced figures) · 50+ verified clinical trials with stage/safety readouts · 17 patient organizations verified worldwide · 40 open research questions + 12 unconnected-dots junctions
The condition in five sentences. Thoracic aortic aneurysm is a usually silent dilatation of the aortic root, ascending aorta, arch, or descending thoracic aorta whose principal danger is catastrophic dissection or rupture. Ascending disease is largely a non-atherosclerotic, genetically influenced degeneration of the aortic media; descending disease behaves more like atherosclerotic aortic disease. Management is anchored to a single crude variable — maximal diameter — with prophylactic surgery around 5.5 cm (lower for genetic aortopathies), even though most dissections occur below that threshold. Medical therapy has proven benefit only as surrogate growth-slowing in Marfan syndrome; no drug is proven for the degenerative majority. The field's frontier is individualized risk prediction beyond diameter, and its first-ever randomized threshold trial reads out ~2035.
Start here: overview.md → then follow a path below. The frontier lives in OPEN-QUESTIONS.md. Growth history lives in LOG.md.
Reading paths¶
- Clinical path — overview → imaging & surveillance → risk stratification → guidelines → medical therapy → surgery → dissection
- Science path — pathophysiology → genetics → hemodynamics & biomechanics → animal models → omics & emerging science
- "What's unknown" path — OPEN-QUESTIONS.md (start with its Dots not yet connected table — the cross-domain junctions no study has joined) → clinical trials landscape → biomarkers → the Open-questions section at the bottom of any page
- Human path — patient experience & advocacy → epidemiology & natural history → statistics sheet
Wiki pages¶
| Section | Page | One-line scope | Status |
|---|---|---|---|
| Foundations | overview.md | The disease, its stakes, and a map of this wiki | curated |
| Foundations | anatomy-and-classification.md | Segments, Crawford extents, definitions, measurement conventions | curated |
| Foundations | epidemiology-and-natural-history.md | Incidence, growth rates, hinge points, size paradox, outcomes | curated |
| Foundations | aortic-dissection.md | Type A/B, acute aortic syndromes, IRAD, post-dissection aorta | curated |
| Genetics | genetics-of-taa.md | Heritability, gene table, gene-validity curation, testing strategy | curated |
| Genetics | syndromic-aortopathies.md | Marfan, Loeys-Dietz, vascular EDS, Turner | curated |
| Genetics | bicuspid-aortopathy.md | The most common aortopathy; hemodynamic-vs-genetic debate | curated |
| Mechanism | pathophysiology.md | Medial degeneration, ECM, SMC switching, the TGF-β paradox | curated |
| Mechanism | hemodynamics-and-biomechanics.md | Wall stress vs strength, 4D-flow WSS, rupture-risk modeling | curated |
| Mechanism | animal-models.md | Mouse model table, what translates and what doesn't | curated |
| Clinical | imaging-and-surveillance.md | Modalities, measurement error, surveillance intervals, screening | curated |
| Clinical | risk-stratification-and-size-thresholds.md | Hinge points, indexed sizes, sex differences, beyond-diameter | curated |
| Clinical | medical-therapy.md | Trial-by-trial drug evidence; the losartan saga; drug cautions | curated |
| Clinical | surgical-and-endovascular-repair.md | Root/arch/descending techniques, outcomes, TEVAR, PEARS | curated |
| Clinical | guidelines.md | 2022 ACC/AHA thresholds with COR/LOE; how guidelines evolved | curated |
| Frontier | biomarkers.md | D-dimer, candidate markers, why none is in guidelines | curated |
| Frontier | omics-and-emerging-science.md | GWAS, PRS, single-cell atlases, ML on imaging, gene-therapy horizon | curated |
| Frontier | clinical-trials-landscape.md | Live NCT-verified trial map; TITAN:SvS; why trials are hard here | curated |
| Human | red-flags-and-safety-concerns.md | Emergency recognition, misdiagnosis data, screening triggers, activity/drug/pregnancy cautions | draft |
| Human | patient-experience-and-advocacy.md | Lived experience, organizations worldwide, awareness campaigns | curated |
Literature layer¶
| Artifact | What it holds |
|---|---|
| BIBLIOGRAPHY.md | Master bibliography: 344 unique papers, PMID-verified, tagged, cited-by-indexed |
| notes/ | 16 structured deep notes on landmark papers (Coady 1997, IRAD 2000, losartan mouse 2006, 2022 guideline, aorta GWAS 2022...) |
| guidelines/REGISTRY.md | 24 clinical guidelines worldwide with supersession chains, disagreements, watch list |
| statistics/STATISTICS.md | ~116 sourced figures: incidence, dissection outcomes, surgical volumes, burden; 9 documented statistical conflicts |
| patient-voice/ | Patient organizations directory, experience themes, annotated sources |
Curation state¶
All 19 pages are status: curated as of 2026-08-28: an independent audit pass re-verified every inline citation against live PubMed/ClinicalTrials.gov records — 263 unique PMIDs and 49 NCTs re-checked, ~600 claim-citation pairs examined, zero fabricated or wrong-paper citations found, ~15 substantive precision errors found and fixed, 13 of the original 15 [unverified] flags resolved with real sources (the rest converted to explicit evidence-gap statements or documented as extraction limitations — 2 such notes remain on guidelines.md). Audit details in LOG.md.