Endovascular Stent-Graft Repair for Penetrating Atherosclerotic Ulcer of the Descending Aorta

Abstract

Because clinical experience with penetrating atherosclerotic ulcer (PAU) of the aorta is limited, there is no general agreement on the optimal therapeutic management of patients with this condition. The authors report on the safety and efficacy data of endovascular stent-graft placement in 10 consecutive patients with PAU diagnosed by transesophageal echocardiography, computed tomography, or magnetic resonance imaging. Stent-grafts were placed through the femoral artery in the 10 patients. The procedure was technically successful in all 10 patients and conversion to open surgery was not required. There were no neurologic complications or deaths among the 10 patients during hospitalization. During follow-up (range 6 to 39 months), all stent-grafts were patent, migration or twisting was not evident. No complications or aorta-related deaths resulted, although two patients did die from other causes. Endovascular stent-graft placement is a safe and effective minimally invasive therapy for patients with complicated PAU.