Penetrating atherosclerotic ulcer of the descending thoracic aorta : Treatment by endovascular stent-graft

To present four cases of penetrating ulcer of the descending thoracic aorta treated by transfemoral insertion of an endoluminal stent-graft. Four patients with penetrating aortic ulcers were reviewed. Three cases were complicated by rupture, false aneurysm, or retrograde dissection. All patients wer...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 1998-11, Vol.21 (6), p.454-458
Main Authors: MURGO, S, DUSSAUSSOIS, L, GOLZARIAN, J, CAVENAILE, J. C, ABADA, H. T, FERREIRA, J, STRUYVEN, J
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aneurysm
Aneurysm, Dissecting - diagnostic imaging
Aneurysm, Dissecting - pathology
Aneurysm, Dissecting - surgery
Aneurysms
AORTA
Aortic Aneurysm, Thoracic - diagnostic imaging
Aortic Aneurysm, Thoracic - pathology
Aortic Aneurysm, Thoracic - surgery
Aortography
Arteriosclerosis
Arteriosclerosis - diagnostic imaging
Arteriosclerosis - pathology
Arteriosclerosis - surgery
Atherosclerosis
Biological and medical sciences
Blood and lymphatic vessels
Blood Vessel Prosthesis Implantation - instrumentation
Blood Vessel Prosthesis Implantation - methods
Cardiology. Vascular system
Cardiovascular system
Catheterization, Peripheral
Complications
Computed tomography
COMPUTERIZED TOMOGRAPHY
Diseases of the aorta
Female
Follow-Up Studies
Graft Survival
Grafting
GRAFTS
Humans
Implants
ISCHEMIA
Male
Medical sciences
Medical treatment
PATIENTS
PNEUMONIA
Pseudoaneurysm
RADIOLOGY AND NUCLEAR MEDICINE
RUPTURES
Stents
SURGERY
Survival
Thorax
Treatment Outcome
ULCERS
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Summary:To present four cases of penetrating ulcer of the descending thoracic aorta treated by transfemoral insertion of an endoluminal stent-graft. 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). 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. 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.
ISSN:0174-1551
1432-086X
DOI:10.1007/s002709900303