Stent-graft treatment of penetrating thoracic aortic ulcers.
OBJECTIVE
To evaluate the efficacy of stent-graft placement for the treatment of penetrating thoracic aortic ulcers.


METHODS
Ten patients (7 men; mean age 73.8 years, range 69-79) were treated for penetrating thoracic aortic ulcers using Talent or Excluder stent-grafts. Preoperative examinations included computed tomographic angiography (CTA), transesophageal echography, and digital subtraction angiography (DSA). Follow-up included predischarge multimodal imaging and periodic CTA scans after discharge. Endoleaks, aortic diameter changes, and clinical complications were tracked.


RESULTS
Technical success was achieved in 100%, but 1 major neurological complication led to death 3 months after the procedure. Radiological follow-up detected 4 early, endoleaks (3 type I and a type II), all of which spontaneously regressed, and 1 secondary type II endoleak. The mean aortic diameter decreased by 22% over a mean 9-month follow-up.


CONCLUSIONS
Aortic ulcers are potentially lethal lesions. Considering its low morbidity and mortality, endovascular repair could widen the treatment options for these lesions.
Kos
Xavier
X
Department of Medical Imaging, University Hospital of Rangueil, Toulouse, France.
Bouchard
Louis
L
Otal
Philippe
P
Chabbert
Valérie
V
Chemla
Patricia
P
Soula
Philippe
P
Meites
Geneviève
G
Joffre
Francis
F
Rousseau
Hervé
H
D000368:Aged; D015901:Angiography, Digital Subtraction; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D001018:Aortic Diseases / Q000473:pathology / Q000601:surgery*; D001161:Arteriosclerosis / Q000473:pathology / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012307:Risk Factors; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer / Q000473:pathology / Q000601:surgery*