Artificial Intelligence in Aorta Aneurysm Management: Translational Applications and Limits

Aortic aneurysms (AAs), both abdominal and thoracic, remain one of the most lethal cardiovascular diseases, with increasing prevalence and incidence, especially in sporadic forms, in our populations, primarily represented by elderly individuals. The high mortality risk is primarily due to delayed management, although their management has shown progress, particularly regarding imaging techniques that facilitate diagnosis and otherwise complex surgical procedures. This is due to the clinical decision-making approach, which, unfortunately, is still based, according to guidelines, on the maximum aortic diameter. The maximum aortic diameter, as repeatedly emphasized, fails to capture the biological and biomechanical complexity of these pathological conditions, which are influenced, among other things, by highly individual factors (genetics, gender, lifestyle, etc.). Thanks to the advent of network medicine and omics sciences, diverse and complex clinical, imaging, and biomarker datasets are available. Artificial intelligence (AI) could process this data to facilitate the complex management of aneurysms and accurately predict risk. AI could prove an excellent tool for aneurysm management, improving risk prediction and radically transforming the way we understand, monitor, and manage aneurysm patients, despite some limitations, as well as improving its therapeutic applications towards personalized strategies. This narrative review provides an overview of these aspects based on current evidence.