Penetrating atherosclerotic ulcer of the descending thoracic aorta: Treatment by endovascular stent-Graft |
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Authors: | Salvatore Murgo MD Luc Dussaussois Jafar Golzarian Jean Christophe Cavenaile Hicham Tarik Abada José Ferreira Julien Struyven |
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Institution: | 1. Department of Radiology, H?pital Erasme, Université Libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium 2. Department of Vascular Surgery, H?pital Erasme, Université Libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium
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Abstract: | Purpose: To present four cases of penetrating ulcer of the descending thoracic aorta treated by transfemoral insertion of an endoluminal
stent-graft.
Methods: Four patients with penetrating aortic ulcers were reviewed. Three cases were complicated by rupture, false aneurysm, or retrograde
dissection. All patients were treated by endovascular stent-graft and were followed by helical computed tomography (CT).
Results: Endovascular stent-graft deployment was successful in all patients. However, in one case we observed a perigraft leak that
spontaneously disappeared within the first month, and two interventions were needed for another patient. Following treatment,
one episode of transient spinal ischemia was observed. The 30-day survival rate was 100%, but one patient died from pneumonia
with cardiac failure 34 days after the procedure. In one patient, helical CT performed at 3 months showed a false aneurysm
independent of the first ulcer. This patient refused any further treatment and suddenly died at home (unknown cause) after
a 6-month follow-up period.
Conclusion: Transluminal placement of endovascular stent-grafts for treatment of penetrating ulcers of the descending thoracic aorta
appears to be a possible alternative to classical surgery. After treatment, follow-up by CT is essential to detect possible
complications of the disease. |
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Keywords: | : Aorta— Aortic ulcer— Thoracic aneurysm— Dissection— Graft— Prosthesis |
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