Endovascular stent-graft repair for penetrating atherosclerotic ulcer in the infrarenal abdominal aorta

Yoshihiko Tsuji, Yosuke Tanaka, Atsushi Kitagawa, Yutaka Hino, Takanori Taniguchi, Koji Sugimoto, Hitoshi Matsuda, Yutaka Okita
2003 Journal of Vascular Surgery  
Purpose: Penetrating atherosclerotic ulcer (PAU) is an ulceration of an atherosclerotic plaque penetrating through the intima, which may lead to intramural hematoma, aneurysm formation, or rupture. This disease is predominantly found in the thoracic aorta and is uncommon in the infrarenal aorta. The effectiveness of endovascular repair of PAU in the infrarenal aorta was retrospectively investigated. Methods: From 1999 to 2002, PAU was diagnosed with computed tomography and magnetic resonance
more » ... ging in the abdominal aorta in four patients. All patients were men; their average age was 78 years. All four patients had hypertension, and two patients had concomitant coronary artery disease. Three patients had abdominal pain or lumbago. Results: All patients underwent endovascular grafting with a Gianturco Z-stent covered with thin-wall woven Dacron graft. Indications for endovascular intervention were aneurysm formation with or without intramural hematoma in two patients and contained rupture with extraaortic hematoma in two patients. The postoperative course was uneventful in all cases, and no endoleak or aneurysm expansion was recognized during follow-up (4-32 months; average, 14 months). Conclusions: Infrarenal aortic lesions caused by PAU were generally localized, and endovascular grafting appears to be a feasible alternative to surgical repair. (J Vasc Surg 2003;38:383-8.) From the
doi:10.1016/s0741-5214(03)00139-3 pmid:12891125 fatcat:6nb3vbzuhjbvjkgue4eemiugoa