Aneurysm development and artery dissection

Warning

In July 2020, the MHRA published advice  about the risk of aneurysm development or artery dissections in patients treated with VEGF-inhibitor therapy.  These are infrequent events, but fatal cases have been reported, mainly related to aortic aneurysm rupture and aortic dissection.

Managing aneurysm and artery dissection risk with VEGF-i therapy

  • Patients should be counselled about the risk of aneurysm and artery dissection prior to treatment, particularly patients with known risk factors, including:  
    • hypertension, history of aneurysm, smoking, diabetes mellitus, coronary, cerebrovascular or peripheral arterial disease, hyperlipidaemia. 
    • other less common risk factors include Marfan syndrome, vascular Ehlers-Danlos syndrome, Takayasu arteritis, giant cell arteritis, Behcet’s disease, and fluoroquinolone use.
  • In patients who receive a systemic VEGF pathway inhibitor, reduce as far as possible any modifiable risk factors such as smoking and hypertension.

Editorial Information

Last reviewed: 05/01/2024

Next review date: 05/01/2027

Author(s): Edinburgh Cancer Centre.

Version: 1.1

Approved By: Authorised by CTAC. Refer to Q-Pulse for approval details.

Reviewer name(s): Stewart J.