Skip to main content
Erschienen in: Herz 6/2011

01.09.2011 | Main topic/CME

Penetrating aortic ulcer

Defining risks and therapeutic strategies

verfasst von: M.S. Bischoff, P. Geisbüsch, A.S. Peters, A. Hyhlik-Dürr, D. Böckler, M.D., Ph.D.

Erschienen in: Herz | Ausgabe 6/2011

Einloggen, um Zugang zu erhalten

Abstract

In addition to classic aortic dissection and intramural hematoma, acute aortic syndrome also includes penetrating aortic ulcers (PAU). The recent advent of highly detailed axial imaging allows closer assessment of PAU and its pathophysiology. However, there is still ongoing discussion about the natural history of the disease, leading to challenging questions concerning the optimal treatment strategy, particularly in asymptomatic patients. In this review, current indications for treatment, with an emphasis on PAU repair in the endovascular era, are discussed.
Literatur
1.
Zurück zum Zitat Amabile P, Grisoli D, Giorgi R, Bartoli JM, Piquet P (2008) Incidence and determinants of spinal cord ischaemia in stent-graft repair of the thoracic aorta. Eur J Vasc Endovasc Surg 35:455–461PubMedCrossRef Amabile P, Grisoli D, Giorgi R, Bartoli JM, Piquet P (2008) Incidence and determinants of spinal cord ischaemia in stent-graft repair of the thoracic aorta. Eur J Vasc Endovasc Surg 35:455–461PubMedCrossRef
2.
Zurück zum Zitat Batt M, Haudebourg P, Planchard PF, Ferrari E, Hassen-Khodja R, Bouillanne PJ (2005) Penetrating atherosclerotic ulcers of the infrarenal aorta: life-threatening lesions. Eur J Vasc Endovasc Surg 29:35–42PubMedCrossRef Batt M, Haudebourg P, Planchard PF, Ferrari E, Hassen-Khodja R, Bouillanne PJ (2005) Penetrating atherosclerotic ulcers of the infrarenal aorta: life-threatening lesions. Eur J Vasc Endovasc Surg 29:35–42PubMedCrossRef
3.
Zurück zum Zitat Botta L, Buttazzi K, Russo V, Parlapiano M, Gostoli V, Di Bartolomeo R, Fattori R (2008) Endovascular repair for penetrating atherosclerotic ulcers of the descending thoracic aorta: early and mid-term results. Ann Thorac Surg 85:987–992PubMedCrossRef Botta L, Buttazzi K, Russo V, Parlapiano M, Gostoli V, Di Bartolomeo R, Fattori R (2008) Endovascular repair for penetrating atherosclerotic ulcers of the descending thoracic aorta: early and mid-term results. Ann Thorac Surg 85:987–992PubMedCrossRef
4.
Zurück zum Zitat Brinster DR (2009) Endovascular repair of the descending thoracic aorta for penetrating atherosclerotic ulcer disease. J Card Surg 24:203–208PubMedCrossRef Brinster DR (2009) Endovascular repair of the descending thoracic aorta for penetrating atherosclerotic ulcer disease. J Card Surg 24:203–208PubMedCrossRef
5.
Zurück zum Zitat Brinster DR, Wheatley GH 3rd, Williams J, Ramaiah VG, Diethrich EB, Rodriguez-Lopez JA (2006) Are penetrating aortic ulcers best treated using an endovascular approach? Ann Thorac Surg 82:1688–1691PubMedCrossRef Brinster DR, Wheatley GH 3rd, Williams J, Ramaiah VG, Diethrich EB, Rodriguez-Lopez JA (2006) Are penetrating aortic ulcers best treated using an endovascular approach? Ann Thorac Surg 82:1688–1691PubMedCrossRef
6.
Zurück zum Zitat Carpenter JP (2002) Delivery of endovascular grafts by direct sheath placement into the aorta or iliac arteries. Ann Vasc Surg 16:787–790PubMedCrossRef Carpenter JP (2002) Delivery of endovascular grafts by direct sheath placement into the aorta or iliac arteries. Ann Vasc Surg 16:787–790PubMedCrossRef
7.
Zurück zum Zitat Certik B, Treska V, Skalicky T, Molacek J, Slauf F (2004) Penetrating aortic ulcer with severe gastrointestinal bleeding. Zentralbl Chir 129:183–184PubMedCrossRef Certik B, Treska V, Skalicky T, Molacek J, Slauf F (2004) Penetrating aortic ulcer with severe gastrointestinal bleeding. Zentralbl Chir 129:183–184PubMedCrossRef
8.
Zurück zum Zitat Cho KR, Stanson AW, Potter DD, Cherry KJ, Schaff HV, Sundt TM 3rd (2004) Penetrating atherosclerotic ulcer of the descending thoracic aorta and arch. J Thorac Cardiovasc Surg 127:1393–1399; discussion 1399–1401PubMedCrossRef Cho KR, Stanson AW, Potter DD, Cherry KJ, Schaff HV, Sundt TM 3rd (2004) Penetrating atherosclerotic ulcer of the descending thoracic aorta and arch. J Thorac Cardiovasc Surg 127:1393–1399; discussion 1399–1401PubMedCrossRef
9.
Zurück zum Zitat Coady MA, Rizzo JA, Hammond GL, Pierce JG, Kopf GS, Elefteriades JA (1998) Penetrating ulcer of the thoracic aorta: what is it? How do we recognize it? How do we manage it? J Vasc Surg 27:1006–1015; discussion 1015–1006PubMedCrossRef Coady MA, Rizzo JA, Hammond GL, Pierce JG, Kopf GS, Elefteriades JA (1998) Penetrating ulcer of the thoracic aorta: what is it? How do we recognize it? How do we manage it? J Vasc Surg 27:1006–1015; discussion 1015–1006PubMedCrossRef
10.
Zurück zum Zitat Coady MA, Rizzo JA, Elefteriades JA (1999) Pathologic variants of thoracic aortic dissections. Penetrating atherosclerotic ulcers and intramural hematomas. Cardiol Clin 17:637–657PubMedCrossRef Coady MA, Rizzo JA, Elefteriades JA (1999) Pathologic variants of thoracic aortic dissections. Penetrating atherosclerotic ulcers and intramural hematomas. Cardiol Clin 17:637–657PubMedCrossRef
11.
Zurück zum Zitat Cooke JP, Kazmier FJ, Orszulak TA (1988) The penetrating aortic ulcer: pathologic manifestations, diagnosis, and management. Mayo Clin Proc 63:718–725PubMed Cooke JP, Kazmier FJ, Orszulak TA (1988) The penetrating aortic ulcer: pathologic manifestations, diagnosis, and management. Mayo Clin Proc 63:718–725PubMed
12.
Zurück zum Zitat Coselli JS, Conklin LD, LeMaire SA (2002) Thoracoabdominal aortic aneurysm repair: review and update of current strategies. Ann Thorac Surg 74:S1881–S1884; discussion S1892–S1888PubMedCrossRef Coselli JS, Conklin LD, LeMaire SA (2002) Thoracoabdominal aortic aneurysm repair: review and update of current strategies. Ann Thorac Surg 74:S1881–S1884; discussion S1892–S1888PubMedCrossRef
13.
Zurück zum Zitat Czermak BV, Waldenberger P, Perkmann R, Rieger M, Steingruber IE, Mallouhi A, Fraedrich G, Jaschke WR (2002) Placement of endovascular stent-grafts for emergency treatment of acute disease of the descending thoracic aorta. AJR Am J Roentgenol 179:337–345PubMed Czermak BV, Waldenberger P, Perkmann R, Rieger M, Steingruber IE, Mallouhi A, Fraedrich G, Jaschke WR (2002) Placement of endovascular stent-grafts for emergency treatment of acute disease of the descending thoracic aorta. AJR Am J Roentgenol 179:337–345PubMed
14.
Zurück zum Zitat Dalainas I, Nano G, Medda M, Bianchi P, Casana R, Ramponi F, Stegher S, Malacrida G, Inglese L, Tealdi DG (2007) Endovascular treatment of penetrating aortic ulcers: mid-term results. Eur J Vasc Endovasc Surg 34:74–78PubMedCrossRef Dalainas I, Nano G, Medda M, Bianchi P, Casana R, Ramponi F, Stegher S, Malacrida G, Inglese L, Tealdi DG (2007) Endovascular treatment of penetrating aortic ulcers: mid-term results. Eur J Vasc Endovasc Surg 34:74–78PubMedCrossRef
15.
Zurück zum Zitat Demers P, Miller DC, Mitchell RS, Kee ST, Chagonjian L, Dake MD (2004) Stent-graft repair of penetrating atherosclerotic ulcers in the descending thoracic aorta: mid-term results. Ann Thorac Surg 77:81–86PubMedCrossRef Demers P, Miller DC, Mitchell RS, Kee ST, Chagonjian L, Dake MD (2004) Stent-graft repair of penetrating atherosclerotic ulcers in the descending thoracic aorta: mid-term results. Ann Thorac Surg 77:81–86PubMedCrossRef
16.
Zurück zum Zitat Eggebrecht H, Herold U, Schmermund A et al (2006) Endovascular stent-graft treatment of penetrating aortic ulcer: results over a median follow-up of 27 months. Am Heart J 151:530–536PubMedCrossRef Eggebrecht H, Herold U, Schmermund A et al (2006) Endovascular stent-graft treatment of penetrating aortic ulcer: results over a median follow-up of 27 months. Am Heart J 151:530–536PubMedCrossRef
17.
Zurück zum Zitat Eggebrecht H, Plicht B, Kahlert P, Erbel R (2009) Intramural hematoma and penetrating ulcers: indications to endovascular treatment. Eur J Vasc Endovasc Surg 38:659–665PubMedCrossRef Eggebrecht H, Plicht B, Kahlert P, Erbel R (2009) Intramural hematoma and penetrating ulcers: indications to endovascular treatment. Eur J Vasc Endovasc Surg 38:659–665PubMedCrossRef
18.
Zurück zum Zitat Estrera AL, Rubenstein FS, Miller CC 3rd, Huynh TT, Letsou GV, Safi HJ (2001) Descending thoracic aortic aneurysm: surgical approach and treatment using the adjuncts cerebrospinal fluid drainage and distal aortic perfusion. Ann Thorac Surg 72:481–486PubMedCrossRef Estrera AL, Rubenstein FS, Miller CC 3rd, Huynh TT, Letsou GV, Safi HJ (2001) Descending thoracic aortic aneurysm: surgical approach and treatment using the adjuncts cerebrospinal fluid drainage and distal aortic perfusion. Ann Thorac Surg 72:481–486PubMedCrossRef
19.
Zurück zum Zitat Estrera AL, Miller CC 3rd, Chen EP et al (2005) Descending thoracic aortic aneurysm repair: 12-year experience using distal aortic perfusion and cerebrospinal fluid drainage. Ann Thorac Surg 80:1290–1296; discussion 1296PubMedCrossRef Estrera AL, Miller CC 3rd, Chen EP et al (2005) Descending thoracic aortic aneurysm repair: 12-year experience using distal aortic perfusion and cerebrospinal fluid drainage. Ann Thorac Surg 80:1290–1296; discussion 1296PubMedCrossRef
20.
Zurück zum Zitat Farooq MM, Kling K, Yamini D, Gelabert HA, Baker JD, Freischlag JA (2001) Penetrating ulceration of the infrarenal aorta: case reports of an embolic and an asymptomatic lesion. Ann Vasc Surg 15:255–259PubMedCrossRef Farooq MM, Kling K, Yamini D, Gelabert HA, Baker JD, Freischlag JA (2001) Penetrating ulceration of the infrarenal aorta: case reports of an embolic and an asymptomatic lesion. Ann Vasc Surg 15:255–259PubMedCrossRef
21.
Zurück zum Zitat Ganaha F, Miller DC, Sugimoto K et al (2002) Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer: a clinical and radiological analysis. Circulation 106:342–348PubMedCrossRef Ganaha F, Miller DC, Sugimoto K et al (2002) Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer: a clinical and radiological analysis. Circulation 106:342–348PubMedCrossRef
22.
Zurück zum Zitat Geisbusch P, Kotelis D, Weber TF, Hyhlik-Durr A, Kauczor HU, Bockler D (2008) Early and midterm results after endovascular stent graft repair of penetrating aortic ulcers. J Vasc Surg 48:1361–1368PubMedCrossRef Geisbusch P, Kotelis D, Weber TF, Hyhlik-Durr A, Kauczor HU, Bockler D (2008) Early and midterm results after endovascular stent graft repair of penetrating aortic ulcers. J Vasc Surg 48:1361–1368PubMedCrossRef
23.
Zurück zum Zitat Giles KA, Pomposelli F, Hamdan A, Wyers M, Jhaveri A, Schermerhorn ML (2009) Decrease in total aneurysm-related deaths in the era of endovascular aneurysm repair. J Vasc Surg 49:543–550; discussion 550–541PubMedCrossRef Giles KA, Pomposelli F, Hamdan A, Wyers M, Jhaveri A, Schermerhorn ML (2009) Decrease in total aneurysm-related deaths in the era of endovascular aneurysm repair. J Vasc Surg 49:543–550; discussion 550–541PubMedCrossRef
24.
Zurück zum Zitat Girn HR, McPherson S, Nicholson T, Mavor AI, Homer-Vanniasinkam S, Gough MJ (2009) Short series of emergency stent-graft repair of symptomatic penetrating thoracic aortic ulcers (PTAU). Vasc Med 14:123–128PubMedCrossRef Girn HR, McPherson S, Nicholson T, Mavor AI, Homer-Vanniasinkam S, Gough MJ (2009) Short series of emergency stent-graft repair of symptomatic penetrating thoracic aortic ulcers (PTAU). Vasc Med 14:123–128PubMedCrossRef
25.
Zurück zum Zitat Gottardi R, Zimpfer D, Funovics M et al (2008) Mid-term results after endovascular stent-graft placement due to penetrating atherosclerotic ulcers of the thoracic aorta. Eur J Cardiothorac Surg 33:1019–1024PubMedCrossRef Gottardi R, Zimpfer D, Funovics M et al (2008) Mid-term results after endovascular stent-graft placement due to penetrating atherosclerotic ulcers of the thoracic aorta. Eur J Cardiothorac Surg 33:1019–1024PubMedCrossRef
26.
Zurück zum Zitat Grabenwoger M, Fleck T, Czerny M et al (2003) Endovascular stent graft placement in patients with acute thoracic aortic syndromes. Eur J Cardiothorac Surg 23:788–793; discussion 793PubMedCrossRef Grabenwoger M, Fleck T, Czerny M et al (2003) Endovascular stent graft placement in patients with acute thoracic aortic syndromes. Eur J Cardiothorac Surg 23:788–793; discussion 793PubMedCrossRef
27.
Zurück zum Zitat Grimm M, Loewe C, Gottardi R et al (2008) Novel insights into the mechanisms and treatment of intramural hematoma affecting the entire thoracic aorta. Ann Thorac Surg 86:453–456PubMedCrossRef Grimm M, Loewe C, Gottardi R et al (2008) Novel insights into the mechanisms and treatment of intramural hematoma affecting the entire thoracic aorta. Ann Thorac Surg 86:453–456PubMedCrossRef
28.
Zurück zum Zitat Gutsche JT, Cheung AT, McGarvey ML et al (2007) Risk factors for perioperative stroke after thoracic endovascular aortic repair. Ann Thorac Surg 84:1195–1200; discussion 1200PubMedCrossRef Gutsche JT, Cheung AT, McGarvey ML et al (2007) Risk factors for perioperative stroke after thoracic endovascular aortic repair. Ann Thorac Surg 84:1195–1200; discussion 1200PubMedCrossRef
29.
Zurück zum Zitat Hirst AE Jr, Barbour BH (1958) Dissecting aneurysm with hemopericardium; report of a case with healing. N Engl J Med 258:116–120PubMedCrossRef Hirst AE Jr, Barbour BH (1958) Dissecting aneurysm with hemopericardium; report of a case with healing. N Engl J Med 258:116–120PubMedCrossRef
30.
Zurück zum Zitat Hughes GC, Lee SM, Daneshmand MA, Bhattacharya SD, Williams JB, Tucker SW Jr, McCann RL (2010) Endovascular repair of descending thoracic aneurysms: results with “on-label” application in the post Food and Drug Administration approval era. Ann Thorac Surg 90:83–89PubMedCrossRef Hughes GC, Lee SM, Daneshmand MA, Bhattacharya SD, Williams JB, Tucker SW Jr, McCann RL (2010) Endovascular repair of descending thoracic aneurysms: results with “on-label” application in the post Food and Drug Administration approval era. Ann Thorac Surg 90:83–89PubMedCrossRef
31.
Zurück zum Zitat Hussain S, Glover JL, Bree R, Bendick PJ (1989) Penetrating atherosclerotic ulcers of the thoracic aorta. J Vasc Surg 9:710–717PubMed Hussain S, Glover JL, Bree R, Bendick PJ (1989) Penetrating atherosclerotic ulcers of the thoracic aorta. J Vasc Surg 9:710–717PubMed
32.
Zurück zum Zitat Hyhlik-Durr A, Geisbusch P, Kotelis D, Bockler D (2010) Endovascular repair of infrarenal penetrating aortic ulcers: a single-center experience in 20 patients. J Endovasc Ther 17:510–514PubMedCrossRef Hyhlik-Durr A, Geisbusch P, Kotelis D, Bockler D (2010) Endovascular repair of infrarenal penetrating aortic ulcers: a single-center experience in 20 patients. J Endovasc Ther 17:510–514PubMedCrossRef
33.
Zurück zum Zitat Kazerooni EA, Bree RL, Williams DM (1992) Penetrating atherosclerotic ulcers of the descending thoracic aorta: evaluation with CT and distinction from aortic dissection. Radiology 183:759–765PubMed Kazerooni EA, Bree RL, Williams DM (1992) Penetrating atherosclerotic ulcers of the descending thoracic aorta: evaluation with CT and distinction from aortic dissection. Radiology 183:759–765PubMed
34.
Zurück zum Zitat Kleisli T, Wheatley GH 3rd (2009) Closure of a penetrating ulcer of the descending aorta using an Amplatzer occluder. Ann Thorac Surg 88:e18–e19PubMedCrossRef Kleisli T, Wheatley GH 3rd (2009) Closure of a penetrating ulcer of the descending aorta using an Amplatzer occluder. Ann Thorac Surg 88:e18–e19PubMedCrossRef
35.
Zurück zum Zitat Kodolitsch Y von, Nienaber CA (1998) Ulcer of the thoracic aorta: diagnosis, therapy and prognosis. Z Kardiol 87:917–927CrossRef Kodolitsch Y von, Nienaber CA (1998) Ulcer of the thoracic aorta: diagnosis, therapy and prognosis. Z Kardiol 87:917–927CrossRef
36.
Zurück zum Zitat Kölbel T (2001) Alternative Zugangswege zur abdominellen und thorakalen Aorta bei Aortenstentbehandlungen. Gefasschirurgie 160–167 Kölbel T (2001) Alternative Zugangswege zur abdominellen und thorakalen Aorta bei Aortenstentbehandlungen. Gefasschirurgie 160–167
37.
Zurück zum Zitat Kos X, Bouchard L, Otal P et al (2002) Stent-graft treatment of penetrating thoracic aortic ulcers. J Endovasc Ther 9(Suppl 2):II25–II31PubMedCrossRef Kos X, Bouchard L, Otal P et al (2002) Stent-graft treatment of penetrating thoracic aortic ulcers. J Endovasc Ther 9(Suppl 2):II25–II31PubMedCrossRef
38.
Zurück zum Zitat Kotelis D, Geisbusch P, Hinz U, Hyhlik-Durr A, von Tengg-Kobligk H, Allenberg JR, Bockler D (2009) Short and midterm results after left subclavian artery coverage during endovascular repair of the thoracic aorta. J Vasc Surg 50:1285–1292PubMedCrossRef Kotelis D, Geisbusch P, Hinz U, Hyhlik-Durr A, von Tengg-Kobligk H, Allenberg JR, Bockler D (2009) Short and midterm results after left subclavian artery coverage during endovascular repair of the thoracic aorta. J Vasc Surg 50:1285–1292PubMedCrossRef
39.
Zurück zum Zitat Kuehl H, Eggebrecht H, Boes T et al (2008) Detection of inflammation in patients with acute aortic syndrome: comparison of FDG-PET/CT imaging and serological markers of inflammation. Heart 94:1472–1477PubMedCrossRef Kuehl H, Eggebrecht H, Boes T et al (2008) Detection of inflammation in patients with acute aortic syndrome: comparison of FDG-PET/CT imaging and serological markers of inflammation. Heart 94:1472–1477PubMedCrossRef
40.
Zurück zum Zitat Lansman SL, Saunders PC, Malekan R, Spielvogel D (2010) Acute aortic syndrome. J Thorac Cardiovasc Surg 140:S92–S97; discussion S142–S146PubMedCrossRef Lansman SL, Saunders PC, Malekan R, Spielvogel D (2010) Acute aortic syndrome. J Thorac Cardiovasc Surg 140:S92–S97; discussion S142–S146PubMedCrossRef
41.
Zurück zum Zitat Lehman SJ, Abbara S, Cury RC et al (2009) Significance of cardiac computed tomography incidental findings in acute chest pain. Am J Med 122:543–549PubMedCrossRef Lehman SJ, Abbara S, Cury RC et al (2009) Significance of cardiac computed tomography incidental findings in acute chest pain. Am J Med 122:543–549PubMedCrossRef
42.
Zurück zum Zitat Litmanovich D, Bankier AA, Cantin L, Raptopoulos V, Boiselle PM (2009) CT and MRI in diseases of the aorta. AJR Am J Roentgenol 193:928–940PubMedCrossRef Litmanovich D, Bankier AA, Cantin L, Raptopoulos V, Boiselle PM (2009) CT and MRI in diseases of the aorta. AJR Am J Roentgenol 193:928–940PubMedCrossRef
43.
Zurück zum Zitat Machaalany J, Yam Y, Ruddy TD, Abraham A, Chen L, Beanlands RS, Chow BJ (2009) Potential clinical and economic consequences of noncardiac incidental findings on cardiac computed tomography. J Am Coll Cardiol 54:1533–1541PubMedCrossRef Machaalany J, Yam Y, Ruddy TD, Abraham A, Chen L, Beanlands RS, Chow BJ (2009) Potential clinical and economic consequences of noncardiac incidental findings on cardiac computed tomography. J Am Coll Cardiol 54:1533–1541PubMedCrossRef
44.
Zurück zum Zitat Movsowitz HD, Lampert C, Jacobs LE, Kotler MN (1994) Penetrating atherosclerotic aortic ulcers. Am Heart J 128:1210–1217PubMedCrossRef Movsowitz HD, Lampert C, Jacobs LE, Kotler MN (1994) Penetrating atherosclerotic aortic ulcers. Am Heart J 128:1210–1217PubMedCrossRef
45.
Zurück zum Zitat Murgo S, Dussaussois L, Golzarian J, Cavenaile JC, Abada HT, Ferreira J, Struyven J (1998) Penetrating atherosclerotic ulcer of the descending thoracic aorta: treatment by endovascular stent-graft. Cardiovasc Intervent Radiol 21:454–458PubMedCrossRef Murgo S, Dussaussois L, Golzarian J, Cavenaile JC, Abada HT, Ferreira J, Struyven J (1998) Penetrating atherosclerotic ulcer of the descending thoracic aorta: treatment by endovascular stent-graft. Cardiovasc Intervent Radiol 21:454–458PubMedCrossRef
46.
Zurück zum Zitat Patel HJ, Williams DM, Upchurch GR Jr, Dasika NL, Deeb GM (2010) The challenge of associated intramural hematoma with endovascular repair for penetrating ulcers of the descending thoracic aorta. J Vasc Surg 51:829–835PubMedCrossRef Patel HJ, Williams DM, Upchurch GR Jr, Dasika NL, Deeb GM (2010) The challenge of associated intramural hematoma with endovascular repair for penetrating ulcers of the descending thoracic aorta. J Vasc Surg 51:829–835PubMedCrossRef
47.
Zurück zum Zitat Peterson BG, Matsumura JS (2008) Creative options for large sheath access during aortic endografting. J Vasc Interv Radiol 19:S22–S26PubMedCrossRef Peterson BG, Matsumura JS (2008) Creative options for large sheath access during aortic endografting. J Vasc Interv Radiol 19:S22–S26PubMedCrossRef
48.
Zurück zum Zitat Piffaretti G, Tozzi M, Lomazzi C, Rivolta N, Caronno R, Castelli P (2007) Endovascular repair of abdominal infrarenal penetrating aortic ulcers: a prospective observational study. Int J Surg 5:172–175PubMedCrossRef Piffaretti G, Tozzi M, Lomazzi C, Rivolta N, Caronno R, Castelli P (2007) Endovascular repair of abdominal infrarenal penetrating aortic ulcers: a prospective observational study. Int J Surg 5:172–175PubMedCrossRef
49.
Zurück zum Zitat Piffaretti G, Tozzi M, Lomazzi C et al (2007) Penetrating ulcers of the thoracic aorta: results from a single-centre experience. Am J Surg 193:443–447PubMedCrossRef Piffaretti G, Tozzi M, Lomazzi C et al (2007) Penetrating ulcers of the thoracic aorta: results from a single-centre experience. Am J Surg 193:443–447PubMedCrossRef
50.
Zurück zum Zitat Quint LE, Williams DM, Francis IR, Monaghan HM, Sonnad SS, Patel S, Deeb GM (2001) Ulcerlike lesions of the aorta: imaging features and natural history. Radiology 218:719–723PubMed Quint LE, Williams DM, Francis IR, Monaghan HM, Sonnad SS, Patel S, Deeb GM (2001) Ulcerlike lesions of the aorta: imaging features and natural history. Radiology 218:719–723PubMed
51.
Zurück zum Zitat Roldan CJ (2011) Penetrating atherosclerotic ulcerative disease of the aorta: do emergency physicians need to worry? J Emerg Med Epub ahead of print Roldan CJ (2011) Penetrating atherosclerotic ulcerative disease of the aorta: do emergency physicians need to worry? J Emerg Med Epub ahead of print
52.
Zurück zum Zitat Salvolini L, Renda P, Fiore D, Scaglione M, Piccoli G, Giovagnoni A (2008) Acute aortic syndromes: role of multi-detector row CT. Eur J Radiol 65:350–358PubMedCrossRef Salvolini L, Renda P, Fiore D, Scaglione M, Piccoli G, Giovagnoni A (2008) Acute aortic syndromes: role of multi-detector row CT. Eur J Radiol 65:350–358PubMedCrossRef
53.
Zurück zum Zitat Scharrer-Pamler R, Kotsis T, Kapfer X, Gorich J, Orend KH, Sunder-Plassmann L (2003) Complications after endovascular treatment of thoracic aortic aneurysms. J Endovasc Ther 10:711–718PubMedCrossRef Scharrer-Pamler R, Kotsis T, Kapfer X, Gorich J, Orend KH, Sunder-Plassmann L (2003) Complications after endovascular treatment of thoracic aortic aneurysms. J Endovasc Ther 10:711–718PubMedCrossRef
54.
Zurück zum Zitat Schelzig H (2004) Endovaskuläre Therapie des symptomatischen Aortenulkus. Gefasschirurgie 201–208 Schelzig H (2004) Endovaskuläre Therapie des symptomatischen Aortenulkus. Gefasschirurgie 201–208
55.
Zurück zum Zitat Shennan T (1934) Dissecting aneurysms. london: his majesty’s stationery office. Medical Research Clinical Special Report Series No 193 Shennan T (1934) Dissecting aneurysms. london: his majesty’s stationery office. Medical Research Clinical Special Report Series No 193
56.
Zurück zum Zitat Stamou SC, Kouchoukos NT (2011) Penetrating ulcer of the ascending aorta. J Am Coll Cardiol 57:1327PubMedCrossRef Stamou SC, Kouchoukos NT (2011) Penetrating ulcer of the ascending aorta. J Am Coll Cardiol 57:1327PubMedCrossRef
57.
Zurück zum Zitat Stanson AW, Kazmier FJ, Hollier LH et al (1986) Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations. Ann Vasc Surg 1:15–23PubMed Stanson AW, Kazmier FJ, Hollier LH et al (1986) Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations. Ann Vasc Surg 1:15–23PubMed
58.
Zurück zum Zitat Sundt TM (2007) Intramural hematoma and penetrating atherosclerotic ulcer of the aorta. Ann Thorac Surg 83:S835–S841; discussion S846–S850PubMedCrossRef Sundt TM (2007) Intramural hematoma and penetrating atherosclerotic ulcer of the aorta. Ann Thorac Surg 83:S835–S841; discussion S846–S850PubMedCrossRef
59.
Zurück zum Zitat Svensson LG, Kouchoukos NT, Miller DC et al (2008) Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts. Ann Thorac Surg 85:S1–S41PubMedCrossRef Svensson LG, Kouchoukos NT, Miller DC et al (2008) Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts. Ann Thorac Surg 85:S1–S41PubMedCrossRef
60.
Zurück zum Zitat Taniguchi I, Morimoto K, Miyasaka S, Marumoto A, Aoki T (2005) Penetrating atherosclerotic ulcer in the juxtarenal abdominal aorta and coronary artery disease: emergency one-stage repair with off-pump coronary surgery. Jpn J Thorac Cardiovasc Surg 53:505–509PubMedCrossRef Taniguchi I, Morimoto K, Miyasaka S, Marumoto A, Aoki T (2005) Penetrating atherosclerotic ulcer in the juxtarenal abdominal aorta and coronary artery disease: emergency one-stage repair with off-pump coronary surgery. Jpn J Thorac Cardiovasc Surg 53:505–509PubMedCrossRef
61.
Zurück zum Zitat Tittle SL, Lynch RJ, Cole PE, Singh HS, Rizzo JA, Kopf GS, Elefteriades JA (2002) Midterm follow-up of penetrating ulcer and intramural hematoma of the aorta. J Thorac Cardiovasc Surg 123:1051–1059PubMedCrossRef Tittle SL, Lynch RJ, Cole PE, Singh HS, Rizzo JA, Kopf GS, Elefteriades JA (2002) Midterm follow-up of penetrating ulcer and intramural hematoma of the aorta. J Thorac Cardiovasc Surg 123:1051–1059PubMedCrossRef
62.
Zurück zum Zitat Torsello GB, Torsello GF, Osada N, Teebken OE, Ratusinski CM, Nienaber CA (2010) Midterm results from the TRAVIATA registry: treatment of thoracic aortic disease with the valiant stent graft. J Endovasc Ther 17:137–150PubMedCrossRef Torsello GB, Torsello GF, Osada N, Teebken OE, Ratusinski CM, Nienaber CA (2010) Midterm results from the TRAVIATA registry: treatment of thoracic aortic disease with the valiant stent graft. J Endovasc Ther 17:137–150PubMedCrossRef
63.
Zurück zum Zitat Troxler M, Mavor AI, Homer-Vanniasinkam S (2001) Penetrating atherosclerotic ulcers of the aorta. Br J Surg 88:1169–1177PubMedCrossRef Troxler M, Mavor AI, Homer-Vanniasinkam S (2001) Penetrating atherosclerotic ulcers of the aorta. Br J Surg 88:1169–1177PubMedCrossRef
64.
Zurück zum Zitat Tsuji Y, Tanaka Y, Kitagawa A et al (2003) Endovascular stent-graft repair for penetrating atherosclerotic ulcer in the infrarenal abdominal aorta. J Vasc Surg 38:383–388PubMedCrossRef Tsuji Y, Tanaka Y, Kitagawa A et al (2003) Endovascular stent-graft repair for penetrating atherosclerotic ulcer in the infrarenal abdominal aorta. J Vasc Surg 38:383–388PubMedCrossRef
65.
Zurück zum Zitat Vilacosta I, San Roman JA, Aragoncillo P et al (1998) Penetrating atherosclerotic aortic ulcer: documentation by transesophageal echocardiography. J Am Coll Cardiol 32:83–89PubMedCrossRef Vilacosta I, San Roman JA, Aragoncillo P et al (1998) Penetrating atherosclerotic aortic ulcer: documentation by transesophageal echocardiography. J Am Coll Cardiol 32:83–89PubMedCrossRef
66.
Zurück zum Zitat Vilacosta I, Aragoncillo P, Canadas V, San Roman JA, Ferreiros J, Rodriguez E (2009) Acute aortic syndrome: a new look at an old conundrum. Heart 95:1130–1139PubMed Vilacosta I, Aragoncillo P, Canadas V, San Roman JA, Ferreiros J, Rodriguez E (2009) Acute aortic syndrome: a new look at an old conundrum. Heart 95:1130–1139PubMed
67.
Zurück zum Zitat Wong DR, Parenti JL, Green SY et al (2011) Open repair of thoracoabdominal aortic aneurysm in the modern surgical era: contemporary outcomes in 509 patients. J Am Coll Surg 212:569–579; discussion 579–581PubMedCrossRef Wong DR, Parenti JL, Green SY et al (2011) Open repair of thoracoabdominal aortic aneurysm in the modern surgical era: contemporary outcomes in 509 patients. J Am Coll Surg 212:569–579; discussion 579–581PubMedCrossRef
Metadaten
Titel
Penetrating aortic ulcer
Defining risks and therapeutic strategies
verfasst von
M.S. Bischoff
P. Geisbüsch
A.S. Peters
A. Hyhlik-Dürr
D. Böckler, M.D., Ph.D.
Publikationsdatum
01.09.2011
Verlag
Urban and Vogel
Erschienen in
Herz / Ausgabe 6/2011
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-011-3513-9

Weitere Artikel der Ausgabe 6/2011

Herz 6/2011 Zur Ausgabe

Main topic/CME

TEVAR

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.