Penetrating atherosclerotic ulcer of the aortic arch
Keywords:
atherosclerosis, aorta, tomography, ulcer
Abstract
Acute aortic syndrome is an acute lesion of the aortic wall involving the aortic tunica media, with a potencial risk of severe complications. The aortic dissection is the main cause (80%), butother entities, such as the intramural hematoma (15%) and the penetrating aortic ulcer (5%), are a less frequent cause. A 49-year-old man, hypertensive, dyslipemic, and without drug treatment, was admitted in the emergency service due to a sudden pain in the mid-chest approximately 3 hr previously. No pain radiation or hemodynamic affectation were apparent. The symptoms were resistant to nitroglycerin and morphine. The chest X rays, electrocardiograms and cardiac enzymes were normal. A computed tomographic angiography was taken because an acute aortic symdrome was suspected (figure 1A). It showed a sacular formation compatible with an aortic ulcer in the left contour of the aortic arch, and situated one-half cm beyond the left subclavian artery and above a zone of parietal calcification. The acute symtomatic penetrating aortic ulcer syndrome carries an equal or greater risk than the typical dissection; therefore invasive treatment was recommended. Because of the potential risk of severe complications
and unpredictable prognosis, a self-expanding endoluminal prosthesis (stent graft), Relay 30 x 100 mm, was implanted for femoral artery access with satisfactory results (figure 1B and 1C).
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References
1. Vilacosta I, San Roman JA. Acute aortic syndrome. Heart. 2001;85:365-8.
2. Evangelista A. Avances en el síndrome aórtico agudo. Rev Esp Cardiol. 2007;60:428-39.
3. Coady MA, Rizzo JA, Elefteriades JA. Pathologic variants of thoracic aortic dicsections. Penetrating atherosclerotic ulcers and intramural hematomas. Cardiol Clin 1999;17:637-57.
4. Ince H, Nienaber CA. Tratamiento de los síndromes aórticos agudos. Rev Esp Cardiol. 2007;60:526-41.
2. Evangelista A. Avances en el síndrome aórtico agudo. Rev Esp Cardiol. 2007;60:428-39.
3. Coady MA, Rizzo JA, Elefteriades JA. Pathologic variants of thoracic aortic dicsections. Penetrating atherosclerotic ulcers and intramural hematomas. Cardiol Clin 1999;17:637-57.
4. Ince H, Nienaber CA. Tratamiento de los síndromes aórticos agudos. Rev Esp Cardiol. 2007;60:526-41.
How to Cite
1.
Gómez R, Fleitas C, Teja C, Carrascosa M, Arrastio X, Celemín I. Penetrating atherosclerotic ulcer of the aortic arch. Biomed. [Internet]. 2008 Sep. 1 [cited 2024 Aug. 18];28(3):317-8. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/70
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Published
2008-09-01
Issue
Section
Imágenes en biomedicina
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