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Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
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Isolated Ruptured Paravisceral Penetrating Aortic Ulcers
Safwan Omran1, Ben Raude1, Larissa Schawe1
1Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of vascular surgery, Berlin, Germany.
Annals of Vascular Surgery
|November 15, 2021
Summary
Isolated ruptured paravisceral penetrating aortic ulcers (PV-PAU) are rare but challenging. Open aortic repair is a reliable treatment, while hybrid and stent-graft techniques are for select cases.
Area of Science:
- Vascular Surgery
- Cardiovascular Research
- Aortic Disease
Background:
- Isolated ruptured paravisceral penetrating aortic ulcers (PV-PAU) represent a rare clinical challenge.
- Understanding their presentation, treatment, and outcomes is crucial for patient management.
Purpose of the Study:
- To investigate the clinical presentation of isolated ruptured PV-PAU.
- To evaluate treatment options and their associated outcomes.
- To assess technical success, perioperative complications, and mortality rates.
Main Methods:
- Retrospective study of patients with acute aortic syndrome from 2015-2020.
- Inclusion criteria: isolated ruptured PV-PAU.
- Endpoints: treatment options, technical success, clinical outcome, complications, and mortality.
Main Results:
- Sixteen patients with isolated ruptured PV-PAU were identified.
- Open aortic repair was the most common treatment (69%), followed by hybrid (19%) and chimney techniques (12%).
- In-hospital and 1-year mortality rates were 6-12%, with 31% postoperative morbidity including renal failure and pneumonia.
Conclusions:
- Ruptured PV-PAU is a rare and complex condition requiring specialized management.
- Open aortic repair demonstrates reliability for treating these ulcers.
- Hybrid and stent-graft techniques are viable for carefully selected patients.
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