The varying morphology and aetiology of arterial aneurysms. A historical review

Abstract

Swelling of the arteries of the extremities is an old disease and has been first reported in ancient Egyptian and Indian texts. The term ‘aneurysm’ has been introduced in the first century by Ruphus from Ephesus. From the beginning, distinction was made between spontaneous and posttraumatic aneurysms. Spontaneous aneurysms were mostly considered to be related to debilitation due to exertion. While the majority of traumatic aneurysms were due to accidental pricking of an artery during bloodletting.
Arterial aneurysms of the aorta and its side branches were first reported in the 16^th century. However, it has to be taken into consideration that post-mortem exams were not done before the Renaissance. Most aortic aneurysms were saccular, eroding the neighbouring organs. This is typical for syphilitic aneurysms. However, although suspected, syphilis has not been recognized as the primary cause of aortic aneurysm until the end of the 19^th century. In the mean time, fusiform ‘degenerative atherosclerotic’ aneurysms, especially on the abdominal aorta, became more frequent. It is now generally accepted that the cause of this aneurysm is multifactorial and exciting scientific research is actually done to elucidate this complex pathology.