[Endovascular stent-graft repair for penetrating atherosclerotic ulcer of the descending aorta].
OBJECTIVE
To summarize the clinical experience and effectiveness of endovascular stent-graft placement for the treatment of penetrating atherosclerotic ulcer of the descending thoracic aorta.


METHODS
From August 2002 to February 2006, 14 patients with penetrating atherosclerotic ulcer accepted endovascular stent-grafts placement. All patients were men, their average age was 60 years. The clinical symptoms included thoracalgia or notalgia or celiodynia (n = 13) and hemoptysis (n = 3). 11 patients had hypertension. All patients were diagnosed by CT or MRI scans. Via the cutdown on a femoral artery at local anesthesia, the stent-graft was placed after completion angiography. Then DSA examine was repeated. X-ray and EBCT or MDCT scans were performed at follow-up.


RESULTS
16 Stent-grafts were successfully placed in 14 patients, in which 2 cases were placed with two stent-grafts respectively. There were Talent stent-grafts (n = 11) and Aegis stent-grafts (n = 5). The diameter of endovascular stent-graft ranged 32 mm to 38 mm exceeding by 10% - 20% of aortic diameter of anchoring zone. Instant angiography revealed no endoleak in 12 patients, minor endoleak in 2 patients. Within the follow-up average 17.2 months, CT scans demonstrated the disappearances of penetrating atherosclerotic ulcer or exclusion of aortic pseudoaneurysm in all patients, and absorption of intramural hematoma in two patients. One patient died of rupture of aortic pseudoaneurysm after one month.


CONCLUSIONS
Penetrating atherosclerotic ulcer can leads to intramural hematoma, dissection, aneurysmal dilatation, pseudoaneurysm, or aortic rupture. Therefore it should be treated once diagnosed. Endovascular stent-graft placement may be an effective treatment for penetrating atherosclerotic ulcer, especially in patients with poor condition.
Jin
Jing-lin
JL
Cardiovascular Institute, Fu Wai Hospital, CAMS and PUMC, Beijing 100037, China.
Huang
Lian-jun
LJ
Yu
Fei-cheng
FC
Lü
Jia-nhua
JN
Jiang
Shi-liang
SL
D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000473:pathology*; D001018:Aortic Diseases / Q000601:surgery / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D014456:Ulcer / Q000601:surgery / Q000628:therapy*