Aneurysm development and artery dissection

Acute Oncology Guidelines
NHS Lothian

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.