Penetrating aortic ulcers and intramural hematoma: Role of endovascular management
Aortic Aneurysm, Abdominal
Blood Vessel Prosthesis Implantation
Penetrating aortic ulcers are characterised by deep ulceration of an atherosclerotic plaque, typically in the descending thoracic aorta, which penetrates from intima into the media of the aortic wall where it may be associated with an intramural hematoma. Intramural hematomas may also present without evidence of intimal tear, flap, or ulcer. Typically affecting an elderly population with multiple cardiovascular risk factors, they may be associated with acute or recurrent thoracic pain and may progress to transmural rupture, often with fatal consequences. Traditional treatment by open surgical techniques has now been complemented by thoracic aortic endovascular therapies and this systematic review focuses on the benefits and risks of these latter modalities.