Endovascular therapy for penetrating ulcers of the infrarenal aorta

Georgiadis, George S.; Trellopoulos, George; Antoniou, George Α.; Georgakarakos, Efstratios; Nikolopoulos, Evagelos S.; Pelekas, Dimitrios; Pitta, Xanthi; Lazarides, Miltos K.

doi:10.1111/ans.12074

Cited by 21 publications

(28 citation statements)

References 32 publications

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“…741,583 PAU are symptomatic in 18e70% causing pain (52%) or acute lower limb ischaemia because of distal embolism (12%) or rupture (4.1e6.9%). 741,[743][744][745] Isolated abdominal aortic dissections (IAAD) are rare and much less common than abdominal aortic dissection associated with thoracic aortic dissection. 746 The dissection is related to a tear in the intimal layer and subsequent blood flow through the tear into the media creating a false lumen.…”

Section: Penetrating Aortic Ulcer Pseudoaneurysm Intramural Haematoma Local Dissection and Saccular Aneurysmmentioning

confidence: 99%

“…Serial imaging surveillance by cross sectional imaging (CTA or MRA) is justified since the natural course is largely unknown 743 , 744 . The assessment of an ulcer includes the measurement of the maximum aortic diameter at the ulcer site, the depth of the ulcer, and the length of the intimal defect (width) at the ulcer site.…”

Section: Penetrating Aortic Ulcer Pseudoaneurysm Intramural Haematoma Local Dissection and Saccular Aneurysmmentioning

confidence: 99%

“…754 Complicated PAU refers to a co-existing extra-aortic haematoma (pseudoaneurysm), embolisation symptoms, recurrent pain, a PAU that initially measures > 20 mm in width or > 10 mm in depth or progression of total abdominal aortic diameter. 743,744,754 Likewise, complicated IMH/IAAD means the presence of recurrent pain, expansion of the IMH, peri-aortic haematoma, intimal disruption, or malperfusion.…”

Section: Penetrating Aortic Ulcer Pseudoaneurysm Intramural Haematoma Local Dissection and Saccular Aneurysmmentioning

confidence: 99%

See 2 more Smart Citations

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

Wanhainen¹,

Verzini²,

Herzeele³

et al. 2019

European Journal of Vascular and Endovascular Surgery

1,959

1,522

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Section: Penetrating Aortic Ulcer Pseudoaneurysm Intramural Haematoma Local Dissection and Saccular Aneurysmmentioning

confidence: 99%

Section: Penetrating Aortic Ulcer Pseudoaneurysm Intramural Haematoma Local Dissection and Saccular Aneurysmmentioning

confidence: 99%

Section: Penetrating Aortic Ulcer Pseudoaneurysm Intramural Haematoma Local Dissection and Saccular Aneurysmmentioning

confidence: 99%

See 1 more Smart Citation

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

Wanhainen¹,

Verzini²,

Herzeele³

et al. 2019

European Journal of Vascular and Endovascular Surgery

1,959

1,522

View full text Add to dashboard Cite

“…Literature review revealed mainly case reports of PAUs at the level of the AA and a rare series of greater than 10 cases. We collected 298 published cases of PAUs of the AA (Table 1) [12,13,17,18,21–61].…”

Section: Discussionmentioning

confidence: 99%

Penetrating Atherosclerotic Ulcers of the Abdominal Aorta: A Case Report and Review of the Literature

Kotsis

Spyropoulos

Asaloumidis

et al. 2019

VSI

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Penetrating atherosclerotic ulcers (PAUs) of the aorta are defined as atherosclerotic lesions with aortic intima and media ulceration, which may lead to a complete rupture of the adventitial wall. The present article aimed to report an unusual case of a surgically treated patient with abdominal aorta PAU with an illustration of the key features and to review and analyze the existing literature data. PAUs typically develop in elderly and hypertensive patients and in patients with advanced atherosclerosis. Although originally described for the descending thoracic aorta, a similar clinicopathological entity also occurs in the abdominal aorta. Patients with symptoms of a PAU should be treated immediately if they are fit for surgery. Exceptive observation by imaging modalities is necessary in patients with asymptomatic small (<2 cm) PAU, with or without focal dissection.

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“…Conservative management with close observation for symptoms and no urgent surgical intervention determined in this natural history study of asymptomatic PUIA stands in contrast to other case series that advocate surgical therapy. 3,4,6,10…”

Section: Discussionmentioning

confidence: 99%

The natural history of penetrating ulcers of the iliac arteries

Flohr

Hagspiel

Jain

et al. 2016

Journal of Vascular Surgery

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PUIA are generally slow-growing and are found incidentally. Most patients with PUIA were in their eighth decade with a history of hypertension and tobacco use. Patients with PUIA frequently have concurrent aortic aneurysm disease that requires intervention. The mortality for this population was high, but was not caused by rupture of a PUIA. Diameter changes noted in the PUIA during follow-up did not suggest ulcer treatment would improve survival.

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Endovascular therapy for penetrating ulcers of the infrarenal aorta

Abstract: Urgent and elective endovascular repair of aPAUs can be achieved with high technical success. The significant co-morbid status of the treated patients is illustrated in the considerable in-hospital mortality and underlines the advantage of such treatment over open surgical repair.

Cited by 21 publications

References 32 publications

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

Penetrating Atherosclerotic Ulcers of the Abdominal Aorta: A Case Report and Review of the Literature

The natural history of penetrating ulcers of the iliac arteries

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