CASE REPORT
Year : 2022  |  Volume : 9  |  Issue : 4  |  Page : 331-334

A wolf in wolf's clothing? The complexities of decision involved with acute thoracic endovascular aortic intervention for penetrating aortic ulcer and intramural hematoma


1 Vascular Department, Royal North Shore Hospital, NSW, Australia; Senior Lecturer, Medicine, Sydney University, NSW, Australia
2 Vascular Department, Royal North Shore Hospital, NSW, Australia

Correspondence Address:
Animesh Singla
Vascular Department, Royal North Shore Hospital, NSW, Australia; Senior Lecturer, Medicine, Sydney University, NSW
Australia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_8_22

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This article provides a case and reviews the considerations involved in acute endovascular stent for penetrating aortic ulcers (PAU)/intramural hematoma (IMH). This case aims to highlight the decision-making and considerations in the acute endovascular management of a patient presenting with PAU and associated IMH. The literature was reviewed including Google Scholar, PubMed, and Embase. Acute aortic syndrome encompasses a spectrum of aortic disease ranging from aortic dissection to PAU and IMH. Whilst classical aortic dissection has been well studied, the PAU/IMH subset of this population is exceedingly rare. Only a handful of case reports have reported on technical considerations for repair. Despite limited natural history data, growing evidence suggests a more aggressive stance is warranted to prevent progression to rupture and late aortic-related mortality. This pathology poses unique challenges in anatomical and technical considerations of repair.


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