[Penetrating aortic ulcers--case report on endovascular therapy]

Area of Science:

• Cardiovascular Surgery
• Interventional Radiology

Background:

• Penetrating aortic ulcers (PAU) are a critical component of acute aortic syndromes, posing a significant risk of mortality.
• PAU commonly affects elderly, hypertensive individuals and can lead to dissection, pseudoaneurysm, or aortic rupture if untreated.

Observation:

• This report details the endovascular treatment of two patients diagnosed with penetrating aortic ulcers.
• The first case involved a 71-year-old woman with a descending thoracic aortic ulcer and intramural hematoma.
• The second case concerned an 80-year-old obese woman with an abdominal aortic pseudoaneurysm secondary to PAU.

Findings:

• Both patients underwent successful endovascular repair using tubular stentgrafts.
• The stentgrafts were implanted via a surgical cut-down of the right femoral artery.
• This approach demonstrated immediate technical success in both complex PAU cases.

Implications:

• Endovascular therapy presents a viable and less invasive alternative to open surgery for high-risk elderly patients with PAU.
• While promising, long-term durability and stability of endovascular repair for PAU require further investigation.
• Early diagnosis and timely intervention are crucial for improving patient prognosis in cases of penetrating aortic ulcers.