The American Journal of Surgery
Volume 193, Issue 4 , Pages 443-447 , April 2007

Penetrating ulcers of the thoracic aorta: results from a single-centre experience

  • Gabriele Piffaretti, M.D.

      Affiliations

    • Vascular Surgery-Department of Surgery, University of Insubria, Varese, Italy
    • Corresponding Author InformationCorresponding author. Vascular Surgery-University of Insubria, Ospedale di Circolo, 21100 viale Borri, 57 Varese, Italy. Tel.: +39332278226; fax: +39332278581.
    • ,
  • Matteo Tozzi, M.D.

      Affiliations

    • Vascular Surgery-Department of Surgery, University of Insubria, Varese, Italy
    • ,
  • Chiara Lomazzi, M.D.

      Affiliations

    • Vascular Surgery-Department of Surgery, University of Insubria, Varese, Italy
    • ,
  • Nicola Rivolta, M.D.

      Affiliations

    • Vascular Surgery-Department of Surgery, University of Insubria, Varese, Italy
    • ,
  • Francesca Riva, M.D.

      Affiliations

    • Vascular Surgery-Department of Surgery, University of Insubria, Varese, Italy
    • ,
  • Simona Maida, M.D.

      Affiliations

    • Vascular Surgery-Department of Surgery, University of Insubria, Varese, Italy
    • ,
  • Roberto Caronno, M.D.

      Affiliations

    • Vascular Surgery-Department of Surgery, University of Insubria, Varese, Italy
    • ,
  • Domenico Laganà, M.D.

      Affiliations

    • Institute of Radiology, University of Insubria, Varese, Italy
    • ,
  • Giampaolo Carrafiello, M.D.

      Affiliations

    • Institute of Radiology, University of Insubria, Varese, Italy
    • ,
  • Salvatore Cuffari, M.D.

      Affiliations

    • Anesthesia and Palliative Care, University of Insubria, Varese, Italy
    • ,
  • Patrizio Castelli, M.D., F.A.C.S.

      Affiliations

    • Anesthesia and Palliative Care, University of Insubria, Varese, Italy

Received 19 May 2006 ,Revised 2 August 2006

References 

  1. Shennan T. In: Dissecting aneurysms. London: Medical Research Council; 1934;p. 193
  2. Stanson AW, Kazmier FJ, Hollier LH, et al. Penetrating atherosclerotic ulcers of the thoracic aorta—natural history and clinicopathologic correlation. Ann Vasc Surg. 1986;1:15–23
  3. Svensson LG, Labib SB, Eisenhauer AC, et al. Intimal tear without hematoma: an important variant of aortic dissection that can elude current imaging techniques. Circulation. 1999;99:1331–1336
  4. Yamada T, Tada S, Harada J. Aortic dissection without intimal rupture—diagnosis with MR imaging and CT. Radiology. 1988;168:347–352
  5. Ganaha F, Miller DC, Sugimoto K, et al. Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer. Circulation. 2002;106:342–348
  6. Coady MA, Rizzo JA, Hammond GL, et al. Penetrating ulcer of the thoracic aorta: what is it? How do we recognize it? How do we manage it?. J Vasc Surg. 1998;27:1006–1015
  7. Nienaber CA, Ince H, Petzsch M, et al. Endovascular treatment of thoracic aortic dissection and its variants. Acta Chir Belg. 2002;102:292–298
  8. Hussain S, Glover JL, Bree R, et al. Penetrating atherosclerotic ulcers of the thoracic aorta. J Vasc Surg. 1989;9:710–717
  9. Toumpoulis IK, Anagnostopoulos CE, Swistel DG, et al. Does EuroSCORE predict length of stay and specific postoperative complications after cardiac surgery?. Eur J Cardiothorac Surg. 2005;27:128–133
  10. Hayashi H, Matsuoka Y, Sakamoto I, et al. Penetrating atherosclerotic ulcer of the aorta: imaging features and disease concept. Radiographics. 2000;20:995–1005
  11. Vilacosta I, San Roman JA, Aragoncillo P, et al. Penetrating atherosclerotic aortic ulcer: documentation by transesophageal echocardiography. J Am Coll Cardiol. 1998;32:83–89
  12. Schoder M, Grabenwoger M, Holzenbein T, et al. Endovascular stent-graft repair of complicated penetrating atherosclerotic ulcers of the descending thoracic aorta. J Vasc Surg. 2002;36:720–726
  13. Cho KR, Stanson AW, Potter DD, et al. Penetrating atherosclerotic ulcer of the descending thoracic aorta and arch. J Thorac Cardiovasc Surg. 2004;127:1393–1399
  14. Tittle SL, Lynch RJ, Cole PE, et al. Midterm follow-up of penetrating ulcer and intramural hematoma of the aorta. J Thorac Cardiovasc Surg. 2002;123:1051–1059
  15. Quint LE, Williams DM, Francis IR, et al. Ulcerlike lesions of the aorta—imaging features and natural history. Radiology. 2001;218:719–723
  16. Harris J, Bis K, Glover J, et al. Penetrating atherosclerotic ulcers of the aorta. J Vasc Surg. 1994;19:90–99
  17. Eggebrecht H, Herold U, Schmermund A, et al. Endovascular stent-graft treatment of penetrating aortic ulcer: results over a median follow-up of 27 months. Am Heart J. 2006;151:530–536
  18. Demers P, Miller DC, Mitchell RS, et al. Stent-graft repair of penetrating atherosclerotic ulcers in the descending thoracic aorta: mid-term results. Ann Thorac Surg. 2004;77:81–86
  19. Murgo S, Dussaussois L, Golzarian J, et al. Penetrating atherosclerotic ulcer of the descending thoracic aorta: treatment by endovascular stent-graft. Cardiovasc Intervent Radiol. 1998;21:454–458
  20. Shumacker HB, King H. Surgical management of rapidly expanding intrathoracic pulsating hematomas. Surg Gynecol Obstet. 1959;109:155–164
  21. Biglioli P, Spirito R, Porqueddu M, et al. Quick, simple clamping technique in descending thoracic aortic aneurysm repair. Ann Thorac Surg. 1999;67:1038–1043
  22. Cooley DA, Golino A, Frazier OH. Single-clamp technique for aneurysms of the descending thoracic aorta: report of 132 consecutive cases. Eur J Cardiothorac Surg. 2000;18:162–167
  23. Coselli JS, LeMaire SA, Conklin LD, et al. Left heart bypass during descending thoracic aortic aneurysm repair does not reduce the incidence of paraplegia. Ann Thorac Surg. 2004;77:1298–1303
  24. Grabenwoger M, Fleck T, Czerny M, et al. Endovascular stent graft placement in patients with acute thoracic aortic syndromes. Eur J Cardiothorac Surg. 2003;23:788–793
  25. Dong Xu S, Zhong Li Z, Huang FJ, et al. Treating aortic dissection and penetrating aortic ulcer with stent-graft: thirty cases. Ann Thorac Surg. 2005;80:864–868
  26. Brittenden J, McBride K, McInnes G, et al. The use of endovascular stents in the treatment of penetrating ulcers of the thoracic aorta. J Vasc Surg. 1999;30:946–949
  27. Melissano G, Astore D, Civilini E, et al. Endovascular treatment of ruptured penetrating aortic ulcers. Ann Vasc Surg. 2005;19:270–275
  28. Kos X, Bouchard L, Otal P, et al. Stent-graft treatment of penetrating thoracic aortic ulcers. J Endovasc Ther. 2002;9(suppl 2):II25–II31

PII: S0002-9610(07)00010-4

doi: 10.1016/j.amjsurg.2006.08.073

The American Journal of Surgery
Volume 193, Issue 4 , Pages 443-447 , April 2007

Article Tools

* Image Usage & Resolution