Intramural hematoma and penetrating aortic ulcer

2007 ◽  
Vol 22 (6) ◽  
pp. 504-509 ◽  
Author(s):  
Thoralf M Sundt
Keyword(s):  
Intramural Hematoma ◽  
Penetrating Aortic Ulcer

Penetrating Aortic Ulcer and Intramural Hematoma

2015 ◽  
Author(s):  
Nanette R. Reed ◽  
Gustavo S. Oderich
Keyword(s):  
Endovascular Repair ◽  
Intramural Hematoma ◽  
Computed Tomographic Angiography ◽  
Classification Systems ◽  
Penetrating Aortic Ulcer ◽  
Computed Tomographic ◽  
Disease Spectrum ◽  
Acute Aortic Syndromes ◽  
Clinical Series ◽  
Aortic Media

Acute aortic syndrome is a spectrum of three overlapping clinical and anatomic diseases: penetrating aortic ulcers, intramural hematomas, and acute aortic dissections. All three entities are part of a disease spectrum, which is characterized by a disruption of the aortic media to a varying degree. Penetrating aortic ulcer, intramural hematoma, and aortic dissection can occur as isolated processes or can be found in association. Although the clinical presentations of the three conditions overlap to some extent, the diagnosis of each specific disease is largely based on specific imaging findings. All three entities are potentially life threatening, so prompt diagnosis and treatment are of paramount importance. Risk factors include hypertension, male sex, tobacco use, atherosclerosis, previous aortic operations, catheter-based interventions, bicuspid aortic valve, and connective tissue disorders. This review summarizes the clinical presentation, diagnosis, indications for repair, and endovascular strategies in patients with acute aortic syndromes. Tables outline early and late outcomes of contemporary clinical series of endovascular repairs of penetrating aortic ulcers and intramural hematomas. Figures show the overlapping features of acute aortic syndromes, progression of penetrating aortic ulcers, a large penetrating aortic ulcer in the proximal thoracic aorta (including representations before endovascular repair and after stent graft coverage), completion angiography demonstrating the patency of chimney and thoracic stent grafts, pre- and postoperative computed tomographic angiography after endovascular repair of a complicated penetrating aortic ulcer, and the Stanford and DeBakey classification systems.  This review contains 8 figures, 4 tables, and 73 references.

Ascending Aortic Dissection, Penetrating Aortic Ulcer, and Intramural Hematoma

2019 ◽  
pp. 127-147
Author(s):  
Rebecca Pinnelas ◽  
Prashant Vaishnava ◽  
Kim A. Eagle
Keyword(s):  
Aortic Dissection ◽  
Intramural Hematoma ◽  
Penetrating Aortic Ulcer

scholarly journals Sex-Based Differences in Outcomes After Thoracic Endovascular Aortic Repair for Penetrating Aortic Ulcer and Intramural Hematoma

2021 ◽  
Vol 74 (3) ◽  
pp. e116-e117
Author(s):  
Priya Patel ◽  
Christina Marcaccio ◽  
Livia de Guerre ◽  
Virendra I. Patel ◽  
Marc L. Schermerhorn ◽  
...  
Keyword(s):  
Intramural Hematoma ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Penetrating Aortic Ulcer ◽  
Aortic Repair

scholarly journals CONSERVATIVE TREATMENT AS A THERAPEUTIC OPTION FOR PENETRATING AORTIC ULCER OF THE AORTIC ARCH IN A PATIENT WITH BICUSPID AORTIC VALVE

2020 ◽  
Vol 73 (7) ◽  
pp. 1580-1582
Author(s):  
Olga Możeńska ◽  
Michał Wojewódzki ◽  
Diana Wiligórska ◽  
Natalia Wiligórska ◽  
Robert J. Gil ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Conservative Treatment ◽  
Aortic Arch ◽  
Bicuspid Aortic Valve ◽  
Therapeutic Option ◽  
Intramural Hematoma ◽  
Type A ◽  
Penetrating Aortic Ulcer ◽  
Asymptomatic Patients ◽  
Acute Aortic Syndromes

Penetrating aortic ulcer (PAU) is ulceration of an aortic atherosclerotic plaque penetrating through the internal lamina into the media. PAU is a rare condition and occurs in 2% – 7% of acute aortic syndromes (AAS); however, the actual incidence is unknown because of asymptomatic patients. One may treat it conservatively as well as surgically. We present a case of a 54-year-old man, who was admitted to hospital due to the exaggeration of exertional chest pain and persistent headaches. During coronary angiography, the suspicion of PAU was raised. Contrast-enhanced computed tomography confirmed the diagnosis. Transesophageal echocardiography showed bicuspid aortic valve with minimal calcification, the dilated ascending aorta, large atherosclerotic plaques in the aortic arch with ulceration (thickness: 5.0 – 5.5mm, diameter: 5 – 6 mm, depth: 3 – 4 mm), without intramural hematoma. Conservative treatment was chosen with uneventful 2-year follow-up. Although surgical management is advocated for patients with PAU type A, we demonstrated that type A PAU can be successfully treated conservatively as well.

Aortic Dissection

2018 ◽  
Author(s):  
Kristine C Orion ◽  
James H Black III
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Intramural Hematoma ◽  
Current Treatment ◽  
Penetrating Aortic Ulcer ◽  
Uncommon Condition ◽  
Best Medical Therapy ◽  
Malperfusion Syndrome ◽  
Prompt Diagnosis ◽  
Stanford Type B

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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