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Cardiovasc Intervent Radiol. 2019 Mar;42(3):321-334. doi: 10.1007/s00270-018-2114-x. Epub 2018 Nov 9.

Penetrating Aortic Ulcer and Intramural Hematoma.

Author information

1
Mayo Clinic Aortic Center and Advanced Endovascular Aortic Research Program, Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA. oderich.gustavo@mayo.edu.
2
Gonda Vascular Center, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA. oderich.gustavo@mayo.edu.
3
Mayo Clinic Aortic Center and Advanced Endovascular Aortic Research Program, Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA.
4
Division of Vascular and Endovascular Surgery, Washington University in St. Louis, Saint Louis, MO, USA.

Abstract

Acute aortic syndromes include a variety of overlapping clinical and anatomic diseases. Penetrating aortic ulcer (PAU), intramural hematoma (IMH) and aortic dissection can occur as isolated processes or can be found in association. All these entities are potentially life threatening, so prompt diagnosis and treatment is of paramount importance. PAU and IMH lesions in the Stanford Type A distribution often require urgent open surgical repair. Lesions in the Stanford Type B distribution may be managed medically in the absence of symptoms or progression; however, a low threshold for endovascular or surgical treatment should be maintained. This review summarizes the clinical presentation, epidemiology, diagnosis, indications for treatment and endovascular strategies in patients with PAU or IMH.

KEYWORDS:

Acute aortic syndrome; Intramural hematoma; Penetrating aortic ulcer

PMID:
30413917
DOI:
10.1007/s00270-018-2114-x
[Indexed for MEDLINE]

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