Presentation, complications, and natural history of penetrating atherosclerotic ulcer disease

Abstract

For PAUs diagnosed on CTA at a single institution, 4.1% were ruptured and 12.9% underwent repair. Close follow-up imaging appears to be indicated for PAUs, particularly in the case of symptomatic disease, which is more likely to require repair and to undergo radiographic progression.

Editor's Choice – Management of Descending Thoracic Aorta Diseases

“…Urgent repair is commonly recommended in this setting. 119,121 Currently, there is a lack of data concerning the natural history of patients with asymptomatic PAU. Progression with pseudoaneurysm formation may occur in 15e50% of cases.…”

“…AD because of a higher risk of peri-operative morbidity and the risk of rupture. 121 Endovascular repair is associated with lower peri-operative morbidity and mortality than OR. 123e125 Nevertheless, the role of endovascular repair in patients with type B IMH is debatable and identifying appropriate indications for treatment is critical.…”

“…Indications were pain and increase of the total aortic diameter at the level of the PAU. 121 In the absence of RCT, the level of evidence for the treatment of PAU is low. There is currently no evidence based treatment recommendation available to support treatment of asymptomatic PAU beyond blood pressure control.…”

“…Morphological changes can develop over time, 7,12,121 and patients with IMH and PAU should have the same surveillance programme as those with AD. In patients with DTAAs or TAAAs, surveillance after initial detection is similar to that for other DTA diseases (Table 3).…”

Síndrome aórtico agudo: Revisión de la literatura y actualización del tema

“…La presentación clínica, así como los factores predisponentes del HI no difieren de la DA clá-sica 9 . La UAP se presenta típicamente en individuos mayores (edad media de 73 años), hipertensos cró-nicos, hiperlipidémicos y tiene una leve predilección por el género masculino (60% de los casos) 10 .…”