Giant aortic arch aneurysm in elderly patient

Here we present you a Type II of Crawford classification aortic aneurysm. Our patient 89-year-old woman with history of hypertension, diabetes mellitus, smoking habits and polyposis of descending/sigmoid colon came to our attention for rectorrhagia, asthenia, dyspnoea and dizziness. A computer tomography exam revealed an aortic arch aneurysm, aortic ectasia at a level of aortic hiatus and infra-renal aortic aneurysmal dilation.In accord to aortic team meeting and patient decision, to refer this lady to medical therapy instead to surgery/hybrid treatment for age patient, comorbidities and high mortality relates to intervention. Aortic arch pathologies are unusual and their treatment is challenging.The aetiology of aortic arch diseases is congenital, chronic, post traumatic, inflammatory, infectious, mechanical and anastomotic, but most frequently is degenerative. Furthermore, the improvement in diagnostic imaging and the aging populations, aortic arch aneurysms have increasingly diagnosed.The incidence of aortic arch diseases is 10-11% and many patients were asymptomatic. Otherwise, many patients came to hospital with catastrophic, life-threatening events and urgent treatment is required. Despite the progress and new technologies have produced new therapeutic options for both cardiac and vascular surgeons is important to highlight the primary role of the aortic team, an interdisciplinary assessment, to find the best tailored treatment, both in acute and chronic setting, for the interest of each patient.