Penetrating atherosclerosis aortic ulcer: a re-appraisal.
BACKGROUND
Penetrating aortic ulcer is a rare pathology, often clinically silent, but potentially fatal when manifesting as an acute aortic syndrome. It is more often detected in recent years, due to ageing of the population and more widespread use of computed tomography. A literature review aims to define the distinct disease entity of penetrating aortic ulcer.


METHODS
Five recent cases of penetrating aortic ulcer, treated in authors' department are reported. A review of English-language medical literature from 1980 to 2015 was undertaken using PubMed and EMBASE databases, to identify studies reporting surgical (open and endovascular) treatment of penetrating aortic ulcer.


RESULTS
From September 2013 to September 2015, five cases of acute aortic syndrome caused by a penetrating atherosclerotic ulcer of the descending thoracic aorta were observed in authors' department. This represents 9% of all acute aortic syndromes admitted to our hospital in the same period. All five patients benefitted from thoracic endovascular stent grafting with a 100% success rate. Natural history and optimal management of penetrating aortic ulcer are outlined according to the most recent insights.


CONCLUSIONS
Penetrating aortic ulcer represents 2-7% of all acute aortic syndromes. Symptomatic penetrating aortic ulcer requires coverage by thoracic endovascular stent grafting according to the recent guidelines.
a Medical Student, C.H.U. Sart Tilman - Liège , Liège , Belgium.
Imane
I
El Hassani
b Department of Cardio-Vascular Surgery , Centre Hospitalier Universitaire de Liège Sart Tilman ? Liège , Belgium.
Hendrik
H
Van Damme
b Department of Cardio-Vascular Surgery , Centre Hospitalier Universitaire de Liège Sart Tilman ? Liège , Belgium.
Etienne
E
Creemers
b Department of Cardio-Vascular Surgery , Centre Hospitalier Universitaire de Liège Sart Tilman ? Liège , Belgium.
Evelyne
E
Boesmans
b Department of Cardio-Vascular Surgery , Centre Hospitalier Universitaire de Liège Sart Tilman ? Liège , Belgium.
Jean-Olivier
JO
Defraigne
D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D014456:Ulcer / Q000000981:diagnostic imaging* / Q000628:therapy*
Penetrating aortic ulcer; TEVAR; aortic dissection; intramural hematoma; stent graft; thoracic aorta