Predictors of Long-Term Aortic Growth and Disease Progression in Patients with Aortic Dissection, Intramural Hematoma, and Penetrating Aortic Ulcer

Acute aortic dissection remains a lethal but uncommon condition. Historically, Stanford type B dissections are managed with best medical therapy whereas Stanford type A dissections are surgically treated. In the last decade, worldwide evidence has been building that has questioned optimal treatment for the former. In this review, we discuss the general features of aortic dissection, the pathophysiology and risk factors, appropriate imaging to make a prompt diagnosis, and current treatment principles and methods. This review contains 82 references, 6 figures and 5 tables. Key words: aortic aneurysm, aortic dissection, intramural hematoma, malperfusion syndrome, penetrating aortic ulcer, thoracoabdominal

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Cardiovascular morbidity and mortality after aortic dissection, intramural hematoma, and penetrating aortic ulcer

Journal of Vascular Surgery ◽

10.1016/j.jvs.2018.12.031 ◽

2019 ◽

Vol 70 (3) ◽

pp. 724-731.e1 ◽

Cited By ~ 9

Author(s):

Salome Weiss ◽

Indrani Sen ◽

Ying Huang ◽

Jill M. Killian ◽

W. Scott Harmsen ◽

...

Keyword(s):

Aortic Dissection ◽

Intramural Hematoma ◽

Cardiovascular Morbidity ◽

Morbidity And Mortality ◽

Penetrating Aortic Ulcer ◽

Cardiovascular Morbidity And Mortality

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Penetrating Atheromatous Ulcer as a Precursor of Aortic Dissection: A Case Report

10.21203/rs.3.rs-67836/v1 ◽

2020 ◽

Author(s):

Priya Shah ◽

Erik Polan

Keyword(s):

Case Report ◽

Aortic Dissection ◽

Ulcer Patient ◽

Intramural Hematoma ◽

Ascending Aorta ◽

Current Case ◽

Penetrating Aortic Ulcer ◽

Ct Angiogram ◽

Acute Aortic Syndromes ◽

Life Threatening

Abstract Background: Acute aortic syndromes include a range of life-threatening conditions with the most familiar entity being aortic dissection. However, variants of aortic dissection also include intimal tear without hematoma, aortic intramural hematoma, and lastly penetrating aortic ulcer (PAU), which will be the focus of this case report. Most PAUs are located in the descending thoracic aorta (85-95%), but they can also occur in the ascending aorta or arch as in the current case.Case Presentation: We report a case of a 77 year old male who presented with chief complaint of intermittent right-handed weakness associated with no numbness or mental status changes. Patient was admitted for stroke workup with unrevealing findings on CT (computed tomography) for acute abnormalities or any hemodynamically significant stenosis on carotid ultrasound. CT angiogram of head/neck revealed a penetrating aortic ulcer of the lateral aspect of the mid to distal ascending aorta. Patient was then transferred for further evaluation to a center of higher level care for further management.Conclusions: Patient was evaluated for surgical repair of penetrating ascending aortic ulcer. Patient underwent serial imaging throughout hospital course which showed grossly similar findings to prior examination and thus no surgical intervention was needed at that time. Patient was recommended to have follow up CT scan in one month to monitor progression of aortic ulcer. Penetrating aortic ulcers are rarely located in the ascending aorta and are considered precursors of life-threatening aortic dissections.

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