Endovascular repair of symptomatic penetrating atherosclerotic ulcer of the thoracic aorta

/Zhang Xiwei

(章希煒，Vascul Surg Dept，Gen Surg，1st Affil Hosp，Nanjing Med Univ，Nanjing 210029)…∥Chin J Gen Surg.-2011，29(9).-755 ～757

ObjectiveTo evaluate endovascular repair(EVAR)of penetrating atherosclerotic ulcer(PAU)of the thoracic aorta.MethodsThere were 12 cases of PAU treated at our department.All the cases had severe acute thoracic pain.Computer tomography angiography(CTA)showed well outlined ulcer in 12 cases，intramural hematoma in 8 cases.EVARs were done under general anaesthesia and 12 stent grafts were used.Two cases received by-pass procedure ahead of EVARs because of main branches involved.Patients were followed up with CTA from 12 months to 4 years(median 36 months).ResultsA total of 12 stent grafts were implanted to 12 patients.The average diameter of stent graft was(35.7 ±2.5)mm(32-40 mm)，length was(163 ±19)mm(152-202 mm).There was a very small internal leakage in one case with large size ulcer after implantation of stent graft，other ulcers were excluded completely.Primary technical success rate was100%.There were no perioperative death and severe complications.All cases were free from symptoms after operation and alive during followup.CTA showed satisfactory results without internal leakage.The small leakage in the case disappeared within 3 months.ConclusionBeing miniinvasive and effective，EVAR is the choice of therapy for symptomatic PAU.11 refs