Diagnosis and Significance of Aortic Blebs

Abstract

Ulcers, diverticula, blisters, and small saccular aneurysm of the aorta are congruent terms for aortic blebs. There are several hypotheses for the formation of these blebs, including local failure of an ongoing compensatory process or plaque ulceration extending out to the adventitia with intramural hematoma. Our knowledge of blebs associated with aortic aneurysms is limited by the poor sensitivity of CT scans. Current recommendations for repair of abdominal aortic aneurysm with blebs are based primarily on standard criteria, including aneurysm size and growth rate. Although data are limited, blebs associated with plaque ulceration in the thoracic aorta appear to represent a high risk group. Intervention is recommended for symptomatic thoracic aortic blebs when feasible. Although these lesions have been treated surgically in the past, they may be ideal cases for intravascular stent graft placement.