Penetrating Atherosclerotic Ulcer

Ulceration of the AORTA by an ATHEROSCLEROTIC PLAQUE by penetrating through and disrupting the internal elastic lamina of the TUNICA INTIMA.

Also Known As:

Aortic Penetrating Ulcers; Aortic Ulcer, Penetrating; Atherosclerotic Ulcer, Penetrating; Penetrating Aortic Ulcers; Penetrating Atherosclerotic Ulcers; Penetrating Ulcer Aortas; Penetrating Ulcer, Aortic; Penetrating Ulcers; Ulcer, Aortic Penetrating; Ulcer, Penetrating; Ulcer, Penetrating Aortic; Ulcer, Penetrating Atherosclerotic; Aortic Penetrating Ulcer; Penetrating Aortic Ulcer; Penetrating Ulcer; Penetrating Ulcer Aorta

Networked: 241 relevant articles (5 outcomes, 11 trials/studies)

Relationship Network

Disease Context: Research Results

Cardiovascular Diseases: 91362
- Vascular Diseases: 15138

Related Diseases

1.	Penetrating Atherosclerotic Ulcer
2.	Hematoma
3.	Aortic Dissection
4.	Thoracic Aortic Aneurysm
5.	Aneurysm (Aneurysms)

Experts

1.	Czerny, Martin: 9 articles (01/2022 - 05/2003)
2.	Böckler, Dittmar: 7 articles (01/2022 - 12/2008)
3.	Eggebrecht, Holger: 7 articles (08/2017 - 05/2003)
4.	Erbel, Raimund: 7 articles (08/2017 - 05/2003)
5.	Ehrlich, Marek: 6 articles (11/2022 - 05/2003)
6.	Schoder, Maria: 6 articles (08/2011 - 10/2002)
7.	Jakob, Heinz: 5 articles (08/2017 - 05/2003)
8.	Grimm, Michael: 5 articles (08/2011 - 06/2008)
9.	Rousseau, Hervé: 4 articles (11/2022 - 06/2003)
10.	Georgiadis, George S: 4 articles (01/2022 - 10/2013)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Penetrating Atherosclerotic Ulcer:

1.	L 644711 (B-3(+))IBA 10/30/2023 - "This study comprised 173 patients (mean age=58±13, range=28-83, 148 men) with thoracic aortic pathologies, including 44 thoracic aortic aneurysms, 113 aortic dissections (9 type A, 4 residual type A, 75 type B, 32 non-A non-B), 3 aortic intramural hematomas, and 13 penetrating aortic ulcers. "
2.	AcidsIBA 09/01/2022 - "Gas formation is a consequence of mixed acid fermentation by these species, which may colonize the inflamed pancreatic tissue by intestinal translocation, hematogenous spread or direct seeding by penetrating ulcer. " 01/01/1999 - ") caused an increase in acid secretion and resulted in penetrating ulcers in the proximal duodenum, and these ulcers gradually healed over 3 weeks. " 06/01/2005 - "We treated 38 atherosclerotic aneurysms, two post-traumatic aortic ruptures, two penetrating ulcers, two chronic dissections and one case was treated for aortic bleeding after voluntary acid ingestion for attempted suicide. " 03/01/1987 - "The anatomically "high" gastric ulcer has an incidence of 27.4%; its main features include a frequent association with the type O blood group; a low basal and stimulated acid output, a high incidence of upper gastrointestinal bleeding, a slower emptying of fluids, and a high percentage of deep penetrating ulcer."
3.	SolutionsIBA 07/01/2011 - "Is endovascular treatment of penetrating aortic ulcer the solution?" 01/01/2018 - "Stent-Assisted Coil Embolization of 2 Complex Juxtarenal Penetrating Aortic Ulcers: An Unconventional Solution." 01/01/1995 - "With ferrous iron or ascorbic acid alone, gastric ulcers did not form, whereas penetrating ulcers were produced by the simultaneous injection of the Fe/ASA solution in a dose-dependent manner. "
4.	Anti-Bacterial Agents (Antibiotics)IBA 05/01/1996 - "We consider that postoperative irradiation, administration of antibiotics, and bile reflux etc. might play significant role in development of the penetrating ulcer." 05/01/1979 - "Antibiotics are indicated in patients with biliary tract disease and penetrating ulcer in whom the risk of secondary infection is considerable. " 06/01/2015 - "Targeted antibiotic therapy with intravenous piperacillin/tazobactam was started and a multi-phase contrast-enhanced abdomen CT-scan was performed at 24 hours from admission showing a saccular aneurysm of the abdominal aorta with a 1 cm penetrating aortic ulcer on posterior wall. "
5.	Biomarkers (Surrogate Marker)IBA 11/17/2016 - "We will use MRI, CT, echocardiography, intraluminal pressures, ECG, computational modelling and serum biomarkers to assess cardiovascular remodelling in two groups of patients with degenerative thoracic aneurysms or penetrating aortic ulcers: (1) patients managed with TEVAR and (2) control patients managed with medical therapy alone. " 08/01/2017 - "The role of D-dimer (D-d) as a diagnostic biomarker and its prognostic value in patients with intramural hematoma (IMH) or penetrating aortic ulcer (PAU) are unknown. "
6.	Cysteamine (Mercaptamine)FDA Link 02/01/1985 - "Cysteamine induces a mixture of erosions, ulcers, and penetrating ulcers. " 08/01/1986 - "Repeated administration of histamine X 2HCl (40 mg/kg X 4) significantly augmented mepirizole (200 mg/kg) or cysteamine (300 mg/kg)-induced duodenal and gastric lesions in rats within 6 hr. Most of the duodenal lesions were penetrating ulcers and were located over the entire duodenum. "
7.	Contrast MediaIBA 05/01/2006 - "Difficulty in demonstrating communication between these collections of contrast material and the adjacent true lumen of the aorta on helical CT examinations and the characteristic location of these lesions along the nonpleural portion of the aortic circumference distinguish them from penetrating ulcers and should suggest the diagnosis of branch artery pseudoaneurysm. " 03/01/2000 - "These pitfalls were attributable to technical factors (eg, improper timing of contrast material administration relative to image acquisition); streak artifacts generated by high-attenuation material, high-contrast interfaces, or cardiac motion; periaortic structures (eg, aortic arch branches, mediastinal veins, pericardial recess, thymus, atelectasis, pleural thickening or effusion adjacent to the aorta); aortic wall motion and normal aortic sinuses; aortic variations such as congenital ductus diverticulum and acquired aortic aneurysm with thrombus; and penetrating atherosclerotic ulcer. "
8.	1,3,4,6- tetra- O- acetyl- 2- azido- 2- deoxyglucopyranose (TAAD)IBA 11/01/2020 - "A total of 148 patients presented with symptomatic and acute or subacute TAAD, TBAD, thoracic aortic aneurysm, or penetrating aortic ulcer for a total of 183 arch vessels. " 11/01/2020 - "An analysis was conducted of early and midterm outcomes of a large series of patients treated with in situ laser fenestration (ISLF) during thoracic endovascular aortic repair (TEVAR) of acute and subacute complex aortic arch diseases, such as Stanford type A aortic dissection (TAAD), type B aortic dissection (TBAD) requiring proximal sealing at zone 2 or more proximal, thoracic aortic aneurysm or pseudoaneurysm, and penetrating aortic ulcer. " 02/01/2022 - "In the general group, 34 patients had a descending aortic aneurysm without dissection or rupture; 71 patients had an aortic dissection (10 - acute, 9 - subacute, 52 - chronic), penetrating aortic ulcer (PAU) - 7, thoracoabdominal aneurysm (Crawford I-II) - 4, isolated aortic arch aneurysm - 2, residual enlargement aorta after previous ascending aortic grafting causing type A acute aortic dissection (TAAD) - 3, primary aortic thrombosis - 1. Patients admitted as elective surgery candidates had switched aortic arch vessels (debranching) in the first stage and TEVAR in the second stage. "
9.	Vascular Endothelial Growth Factor A (Vascular Endothelial Growth Factor)IBA 09/01/2015 - "Treatment of mucosally injured WT mice with a VEGFR inhibitor resulted in the development of penetrating ulcers, further demonstrating that VEGF is critical for mucosal repair. " 09/01/2015 - "Prostaglandin I₂ (PGI₂) stimulated VEGF-dependent angiogenesis to prevent penetrating ulcers. "
10.	15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic AcidIBA 02/01/1988 - "Local intra-arterial infusion of U-46619 (100-500 ng/kg/min for 10 min) induced dose-dependent macroscopic damage in both the corpus and antral regions, characterized as vasocongestion, disruption and haemorrhage, with deep penetrating ulcers in the antral mucosa. "

Therapies and Procedures

1.	Stents 04/25/2006 - "Endovascular stent-graft placement may be an effective treatment for penetrating atherosclerotic ulcer, especially in patients with poor condition." 09/01/2011 - "Early aggressive medical treatment combined with prophylactic aortic stent-grafting is a safe and effective treatment modality for IMH patients with penetrating aortic ulcers in the descending aorta." 11/01/2003 - "To date, there is limited experience with endovascular repair in penetrating atherosclerotic ulcer, suggesting that endovascular stent-graft repair is safe and effective. " 12/01/2021 - "To describe the use of large-diameter balloon-expandable stent-grafts (BeGraft aortic stent-graft, Bentley InnoMed GmbH, Hechingen, Germany) in the treatment of infrarenal penetrating aortic ulcer (iPAU). " 12/01/2021 - "Multicenter Experience With Large Diameter Balloon-Expandable Stent-Grafts for the Treatment of Infrarenal Penetrating Aortic Ulcers."
2.	Endovascular Aneurysm Repair 06/01/2016 - "The aim of the study was to provide a literature review of thoracic endovascular aortic repair (TEVAR) outcomes for penetrating ulcer of the aorta. " 01/20/2023 - "Treatment of asymptomatic complicated penetrating aortic ulcers (PAUs) with thoracic endovascular aortic repair (TEVAR) provides excellent clinical success and acceptable complication and reintervention rates. " 01/20/2023 - "In penetrating aortic ulcers (PAUs), limited data support tubular thoracic endovascular aortic repair (TEVAR) as a viable treatment option. " 11/01/2022 - "To acquire adequate proximal landing zones for penetrating aortic ulcers in the proximal descending aorta or aortic arch, the left subclavian artery (LSA) is usually covered during thoracic endovascular aortic repair. " 06/01/2022 - "Thoracic endovascular aortic repair (TEVAR) is the treatment of choice for thoracic aorta diseases including penetrating aortic ulcer (PAU). "
3.	Therapeutics 09/01/2021 - "Endovascular therapy has come to the forefront of penetrating atherosclerotic ulcers management, often considered first line therapy. " 02/01/2014 - "Authors response to letter to the editor re: "Surgical or endovascular therapy of abdominal penetrating ulcers and their natural history: a systematic review"." 10/01/2013 - "Surgical or endovascular therapy of abdominal penetrating aortic ulcers and their natural history: a systematic review." 10/01/2013 - "Endovascular therapy for penetrating ulcers of the infrarenal aorta." 11/01/2006 - "Compared with historical surgical results, endovascular therapy for penetrating aortic ulcers of the descending thoracic aorta appears to have less operative mortality and is as equally effective as open surgical repair. "
4.	Prostheses and Implants (Prosthesis) 08/01/2021 - "Herein, we report a case of Penetrating Aortic Ulcer (PAU) post release of Thoracic endoprosthesis. " 08/01/2021 - "Penetrating aortic ulcer post migration of thoracic aortic endoprosthesis: Case report." 01/01/2019 - "KEY WORDS: Aortic arch, Endoprosthesis, Evar, Penetrating ulcer." 02/01/2012 - "Treatment of penetrating aortic ulcer by endoprosthesis: a single center experience." 07/28/2011 - "Treatment of penetrating aortic ulcer by endoprosthesis: a single center experience."
5.	Conservative Treatment 01/01/2020 - "Conservative treatment as a therapeutic option for penetrating aortic ulcer of the aortic arch in a patient with bicuspid aortic valve." 08/01/2009 - "Open surgery was the treatment of choice for the ruptured aneurysm, while conservative treatment was recommended for the associated penetrating atherosclerotic ulcers of the descending aorta." 10/01/2010 - "Patients who had penetrating atherosclerotic ulcers, maximum aortic diameter >45 mm, hematoma thickness >10 mm, or sustained chest or back pain despite maximal medical therapy received endovascular stent-grafts (n=33; mean age 60 years, range 33-86), while other patients (n=23; mean age 56 years, range 29-83) received conservative therapy. " 08/01/1988 - "Conservative management with sucralfate and ranitidine allowed endoscopically proven healing of the penetrating ulcer with subsequent successful reuse of the catheter."