2002
DOI: 10.1161/01.cir.0000022164.26075.5a
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Prognosis of Aortic Intramural Hematoma With and Without Penetrating Atherosclerotic Ulcer

Abstract: Background-Advances in imaging techniques have increased the recognition of aortic intramural hematomas (IMHs) and penetrating atherosclerotic ulcers (PAUs); however, distinction between IMH and PAU remains unclear. We intended to clarify differences between IMH coexisting with PAU and IMH not associated with PAU by comparisons of clinical features, imaging findings, and patient outcome to derive the optimal therapeutic approach. Methods and Results-We performed a retrospective analysis of 65 symptomatic patie… Show more

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Cited by 478 publications
(290 citation statements)
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“…[61][62][63][64][65] Noninvasive imaging of aortic ulceration has been improved by tomographic scanning and has shed light on pathophysiology and etiology. The ulcers seem to predominantly affect the descending thoracic aorta, as well as the abdominal aorta, in localized fashion; branch vessel compromise is rare.…”
Section: Plaque Rupture/ulcerationmentioning
confidence: 99%
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“…[61][62][63][64][65] Noninvasive imaging of aortic ulceration has been improved by tomographic scanning and has shed light on pathophysiology and etiology. The ulcers seem to predominantly affect the descending thoracic aorta, as well as the abdominal aorta, in localized fashion; branch vessel compromise is rare.…”
Section: Plaque Rupture/ulcerationmentioning
confidence: 99%
“…The ulcers seem to predominantly affect the descending thoracic aorta, as well as the abdominal aorta, in localized fashion; branch vessel compromise is rare. However, ulcers may penetrate intimal borders, often appearing in nipple-like projection with an adjacent hematoma 62,65 ; symptomatic ulcers and/or those with signs of deep erosion are more likely to rupture than others.…”
Section: Plaque Rupture/ulcerationmentioning
confidence: 99%
See 1 more Smart Citation
“…Indications for endovascular treatment of IMH are basically the same as those for dissection: medical treatment with serial imaging follow-up for type B aortic IMH and immediate surgical treatment for type A aortic IMH [21,38]. During the followup period of type B aortic IMH, if a gradual increase in IMH thickness, luminal dilatation, pseudoaneurysm formation (or ulcer-like projection), or progression to aortic dissection occurs, surgical or endovascular treatment is required [38].…”
Section: Intramural Hematomamentioning
confidence: 99%
“…[23][24][25] The relation between VV rupture and intramural hematoma was first established in 1920 by Krukenberg et al; 26 since then, IMH has been accepted as a possible cause. IMH is by definition distinguished from acute dissection and hematoma secondary to penetrating ulcer due to the absence of an intimal rupture site.…”
Section: Vasa Vasorum and Intramural Hematomamentioning
confidence: 99%