Percutaneous management of penetrating aortic ulcer

Penetrating aortic ulcer is a variant of classic aortic dissection having distinct histopathological characteristics. If not appropriately treated, it evolves to combined morbidity and mortality rates as high as those of classic dissection. This condition, therefore, warrants special attention with accurate diagnosis and treatment. Percutaneous management using endoprosthesis is the method of choice, since the patients are usually elderly and have comorbidities that would increase the complication rates of traditional surgery. A 78-year-old woman complaining of thoracic pain was admitted to the hospital; her pain had been radiating to the interscapular and left lumbar regions for four months. Upon diagnostic investigation, a penetrating aortic ulcer was found, and after being successfully treated percutaneously with stent implantation, the patient became asymptomatic and is under outpatient follow-up.