Penetrating Aortic Ulcers – Casuistry of Endovascular Therapy
Raupach J., Lojík M., 1Beran L., 2Harrer J., Chovanec V., Krajina A. Ryška P.
Radiologická klinika FN, Hradec Králové 1Interní klinika FN, Hradec Králové 2Kardiochirurgická klinika FN, Hradec Králové |
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Summary:
We report our experience with two cases of endovascular treatment of penetrating aortic ulcers (PAU). The first
patient was a 71-year-old woman with 30 mm width aortic ulcer accompanied by intramural hematoma of the
descending thoracic aorta. The second patient was an 80-year-old obese woman with 50 mm pseudoaneurysma of the
abdominal aorta, which was result of PAU. Both patients were successfully treated by means of tubular stentgraft,
implanted from surgical cut down of the right femoral artery. Penetrating aortic ulcer represents localized, potentially
lethal pathology of the aorta. Together with dissection and intramural hematoma belongs among the acute aortic
syndromes. During nature course PAU can progress to the acute classic dissection, pseudoaneurysma or rupture of the
aorta. It is principally disease of elderly hypertensive patients. Early diagnosis and appropriate therapy improves
prognosis of patients with PAU. Open surgical repair with synthetic graft has been the gold standard of treatment but
endovascular therapy is an attractive option in risk elderly patients. It seems to be a safe, effective treatment but
stability of results of this method should be proved.
Key words:
penetrating aortic ulcer, stent-graft, endovascular, acute aortic syndrome.
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