Radiological features of uncommon aneurysms of the cardiovascular system

Table 1 Summary of findings, complications, and treatment in uncommon aneurysms

Aneurysm	Findings	Complications	Treatment
Giant aneurysm	Thoracic aortic aneurysm > 10 cm	Rupture; mediastinal compression	Surgical repair
Pseudoaneurysm	Saccular, thin-neck aneurysm at aortic arch	Rupture; infection	Surgical repair
Ductus aneurysm	Saccular, thin-neck aneurysm at aortic isthmus	Rupture; infection	Surgical repair
Mycotic/inflammatory aneurysm	Mycotic: Saccular outpouching with surrounding inflammatory stranding, fluid collection, gas; inflammatory: Broader based aneurysm with surrounding inflammatory stranding	Rupture	Mycotic: Antibiotics, surgical repair; inflammatory: Anti-inflammatory medications, surgical repair
Aneurysm with fistula	Aneurysm with connection to adjacent bowel or vessel	Rupture; GI bleed (aortoesophageal, aortoenteric); sepsis (aortoesophageal, aortoenteric); cardiac failure (aortocaval)	Surgical repair
Ventricular aneurysm	Ventricular aneurysm containing myocardium (true) or absent myocardium (false)	Rupture with tamponade; thromboembolism	True: Medical/interventional therapy; false: Surgical repair
Atrial/ventricular septal aneurysm	Atrial: Focal outpouching at fossa ovalis > 1.5 cm; Ventricular: Focal outpouching at membranous septum	Thromboembolism (atrial); arrhythmias (atrial); outflow tract obstruction (ventricular); shunt (ventricular); rupture (ventricular)	Atrial: Medical/stroke prevention; ventricular: Unknown1
Coronary artery aneurysm	Focal (aneurysm) or diffuse (ectasia) dilatation greater 1.5 times normal diameter	Myocardial infarction; rupture; fistula formation	Medical therapy; surgical repair
Sinus of Valsalva aneurysm	Outpouching of sinus without aortic aneurysm; "windsock" deformity	Rupture; thromboembolism; infection	Surgical repair
Aberrant right subclavian aneurysm	Aneurysm at origin of aberrant right subclavian artery	Esophageal, airway compression; rupture; thromboembolism	Surgical repair
Brachiocephalic artery aneurysm	Aneurysm of brachiocephalic artery ± aortic arch	Mediastinal compression; rupture; infection	Surgical repair
		Thromboembolism
Pulmonary artery aneurysm and pseudoaneurysm	Pulmonary artery dilatation greater 1.5 times normal diameter	Right heart failure; rupture	Unknown1
SVC aneurysm	Aneurysmal dilatation of SVC	Thromboembolism; rupture	Unknown1

¹Unknown: No clear consensus on treatment exits or not enough experience. SVC: Superior vena cava; GI: Gastrointestinal.