Endovascular Repair of Penetrating Aortic Ulcers: Indications and Single-Center Mid-Term Results.

Abstract

BACKGROUND:

Although endovascular repair is used to treat penetrating aortic ulcers (PAUs), the indications for endovascular repair in PAUs remain controversial. The current study evaluated the mid-term results of endovascular repair for PAUs and further explored the endovascular indications for PAUs.

METHODS:

We retrospectively reviewed the clinical data of patients who were diagnosed with PAUs and underwent endovascular repair in our department from October 2018 to August 2020. Endovascular indication included persistent or recurring symptoms, a maximum diameter of the PAU of greater than 20 mm, a maximum depth of the PAU of greater than 10 mm, an increase in the diameter of the aorta at the ulcer of greater than 10 mm annually, and multiple ulcers at the same or adjacent level of the aorta. Patient characteristics, anatomical parameters of the PAU, characteristics of endovascular repair and follow-up data were analyzed.

RESULTS:

15 patients were included in the study. 3 patients had PAUs in the aortic arch, 6 PAUs were in the descending thoracic aorta, 4 PAUs were in the abdominal aorta, and 2 PAUs were in the descending thoracic and abdominal aortas. The average age was 70.60±8.27 years. Eight patients were symptomatic. The average depth of the PAUs was 7.32±2.74 mm, and the average diameter was 15.03±6.10 mm. The average operation time was 95.60±33.11 min. Postoperative hospital stay was 3.33±0.61 days. A left subclavian artery chimney stent was implanted in 3 aortic arch cases and 1 occluded case without adverse symptoms during the follow-up period. A bifurcated stent graft was placed in 3 abdominal aorta cases and exhibited good patency during the follow-up period. The duration of follow-up ranged from 3 to 24 months. The follow-up results showed that all PAUs were treated satisfactorily by endovascular repair, and no endoleaks or stent graft-related complications occurred.

CONCLUSION:

Endovascular repair is a safe and effective treatment for PAUs, and it may be safely performed in elderly patients and patients with comorbidities. The endovascular indications for PAUs must be further studied and optimized.

• Authors: Rongjie Zhang, Long Sun, Wei Sun, Shiwei Yang, Yingxue Hao
• Journal: Annals of vascular surgery (Ann Vasc Surg) Vol. 81 Pg. 129-137 (Apr 2022) ISSN: 1615-5947 [Electronic] Netherlands
• PMID: 34775025 (Publication Type: Journal Article)
• Copyright: Copyright © 2021. Published by Elsevier Inc.

Topics

• Aged
• Aorta, Thoracic (diagnostic imaging, surgery)
• Aortic Diseases (complications, diagnostic imaging, surgery)
• Blood Vessel Prosthesis Implantation (adverse effects)
• Endovascular Procedures (adverse effects)
• Humans
• Middle Aged
• Retrospective Studies
• Risk Factors
• Stents
• Time Factors
• Treatment Outcome
• Ulcer (complications, diagnostic imaging, surgery)