Penetrating atherosclerotic ulcer of the descending thoracic aorta: Treatment by endovascular stent-Graft

Abstract

Transluminal placement of endovascular stent-grafts for treatment of penetrating ulcers of the descending thoracic aorta appears to be a possible alternative to classical surgery. After treatment, follow-up by CT is essential to detect possible complications of the disease.

Percutaneous stenting of acquired thoracic aorta occlusive disease

“…Stent grafts have been used successfully in repairing descending thoracic aorta penetrating ulcers and aneurysms with low complication rates. In the series reported by Murgo et al [18], one out of the four patients developed transient spinal ischemia after stent grafting of penetrating thoracic aorta ulcers. Ehrlich et al [19] showed that endovascular stent grafting for descending thoracic aneurysm had favorable outcomes compared to conventional surgical repair.…”

Endoluminal versus open repair of descending thoracic aortic rupture: a review of the National Trauma Databank

“…As the published evidence consists of nonrandomized small population studies there are no long-term data for this typically young patient population and the role of ELG for BAI has been evolving. Retrospective series have shown successful emergency repair of acute thoracic aortic disease by endovascular stent grafting [Czermak et al 2000;Dake et al 1999;Nienaber et al 1999;Murgo et al 1998;Semba et al 1997]. Its use eliminates the need for extensive surgery with the attendant risks of anticoagulation, single-lung ventilation, aortic cross-clamping, and thoracotomy.…”

Penetrating aortic ulcer

“…Endovascular repair should aim for exclusion of all suspicious lesions neighboring the ulcer as the formation of de novo penetrations at the end of the deployed stent-graft has been described [13,45,54]. Sufficient landing zones represent a keystone of successful and durable PAU exclusion.…”