title: CT imaging findings and their relevance to the clinical outcomes after stent graft repair of penetrating aortic ulcers: six-year, single-center experience.
abstract: OBJECTIVE
  To present the computed tomographic (CT) imaging findings and their relevance to clinical outcomes related to stent graft placement in patients with penetrating aortic ulcers (PAUs).
  
  
  METHODS
  Medical and imaging records and imaging studies were reviewed for consecutive patients who underwent stent graft repair of a PAU. The distribution and characteristics of the PAU, technical success of stent graft repair, procedure-related complications, associated aortic wall abnormalities, and outcomes of the PAUs at follow-up CT scans were evaluated.
  
  
  RESULTS
  Fifteen patients underwent endovascular treatment for PAU. A total of 87% of the PAUs were in the proximal (n = 8) or distal (n = 5) descending thoracic aorta. There was a broad spectrum of PAU depth (mean, 7.9 ± 5.6 mm; range 1.5-25.0 mm) and diameter (mean, 13.5 ± 9.7 mm; range 2.2-41.0 mm). Atherosclerosis of the thoracic aorta and intramural hematoma were associated in 53 and 93% of the patients, respectively. Technical success was achieved in 100%. Two or more stent grafts were used in five patients. Endoleaks were observed in two patients within 2 weeks of the procedure, both of which resolved spontaneously. At follow-up CT scanning, regression and thrombosis of the PAUs were observed in all patients. The average patient survival was 61.8 months, with an overall mortality of 13% (2 of 15) at follow-up. Neither death was related to the endograft device or the PAU.
  
  
  CONCLUSIONS
  Endovascular stent graft placement was safe and effective in causing regression and thrombosis of PAUs in this small series of patients. Two or more stent grafts were used in five patients (33%) with associated long-segmental atherosclerotic changes of the thoracic aorta or intramural hematoma.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwongil 86, Pungnap-2dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.forename: John F
authors.initials: JF
authors.lastname: Angle
authors.forename: Auh Whan
authors.initials: AW
authors.lastname: Park
authors.forename: Curtis
authors.initials: C
authors.lastname: Anderson
authors.forename: Saher S
authors.initials: SS
authors.lastname: Sabri
authors.forename: Ulku C
authors.initials: UC
authors.lastname: Turba
authors.forename: John A
authors.initials: JA
authors.lastname: Kern
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Cherry
authors.forename: Alan H
authors.initials: AH
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D015897:Comorbidity; D003287:Contrast Media; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015607:Stents; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer / Q000000981:diagnostic imaging* / Q000601:surgery*
chemical_list: D003287:Contrast Media