With syphilitic aneurysms, serologic tests, especially the fluorescent treponemal antibody absorption and Treponema pallidum immobilization tests, are most often positive. However, aneurysms in patients with Marfan's syndrome are prone to rupture, so elective surgical repair is recommended for aneurysms 5 to 6 cm. Surgical repair consists of resection of the aneurysm and replacement with a synthetic conduit. The Bentall repair consists of resection of the dilated ascending aorta down to the aortic annulus, with excision of the coronary arteries around a button of aortic wall. The coronary arteries are then reimplanted into the graft.
Some surgeons use a homograft of the proximal aorta and aortic valve instead of synthetic materials.
Traumatic aneurysms are prone to rupture and should be repaired surgically. The most common peripheral arterial aneurysms are those of the popliteal arteries. Although popliteal aneurysms rarely rupture, they may serve as a focus for abrupt thrombotic occlusion of the involved popliteal artery, jeopardizing the foot on the affected side. Thrombus within the aneurysms may lead to distal embolism. Arteriography can also confirm the diagnosis and assess the circulation distal to the aneurysm.