Penetrating atherosclerotic ulcer
Arturo Evangelista1,2, Sergio Moral3
1Cardiology Department, Hospital General Universitari Vall d'Hebron, VHIR, CIBER-CV.
Current Opinion in Cardiology
|September 14, 2020
Summary
Penetrating aortic ulcers (PAU) often require no immediate intervention. However, accurate diagnosis using imaging is crucial, especially when PAU causes acute aortic syndromes, necessitating urgent treatment.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Vascular Surgery
Background:
- Penetrating aortic ulcer (PAU) involves atherosclerotic plaque penetrating the internal elastic lamina into the aortic media.
- Advances in imaging present challenges in differentiating PAU from other aortic ulcerations.
Purpose of the Study:
- To review current understanding of PAU.
- To highlight recent clinical and imaging findings.
- To assist in treatment decision-making for PAU.
Main Methods:
- Literature review focusing on clinical context and imaging characteristics of PAU.
- Analysis of diagnostic challenges and management strategies.
Main Results:
- Most PAUs are asymptomatic and do not require urgent invasive treatment.
- PAU leading to acute aortic syndrome warrants emergency invasive therapy.
- Differential diagnosis from ulcerated plaques and intramural hematomas is critical due to differing risks and management.
Conclusions:
- Accurate differential diagnosis of PAU is essential for appropriate prognosis and management.
- Imaging plays a key role in diagnosing PAU.
- Urgent invasive treatment is recommended for PAU causing acute aortic syndromes.
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