Penetrating Aortic Ulcer and Intramural Hematoma

Acute aortic syndromes include a variety of overlapping clinical and anatomic diseases. Penetrating aortic ulcer (PAU), intramural hematoma (IMH) and aortic dissection can occur as isolated processes or can be found in association. All these entities are potentially life threatening, so prompt diagn...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2019-03, Vol.42 (3), p.321-334
Main Authors: Oderich, Gustavo S., Kärkkäinen, Jussi M., Reed, Nanette R., Tenorio, Emanuel R., Sandri, Giuliano A.
Format: Article
Language:English
Subjects:
Aged
Aneurysm, Dissecting - complications
Aneurysm, Dissecting - diagnostic imaging
AORTA
Aorta - diagnostic imaging
Aorta, Thoracic
Aortic Diseases - complications
Aortic Diseases - diagnostic imaging
Aortic dissection
BIOMEDICAL RADIOGRAPHY
Cardiology
Cardiovascular system
Computed Tomography Angiography
COMPUTERIZED TOMOGRAPHY
DIAGNOSIS
Disease Progression
ELECTROCARDIOGRAMS
EPIDEMIOLOGY
Female
Hematoma
Hematoma - complications
Hematoma - diagnostic imaging
HEMATOMAS
Humans
Imaging
INFLAMMATION
Lesions
LYMPH VESSELS
Male
Medicine
Medicine & Public Health
NMR IMAGING
Nuclear Medicine
PAIN
PATIENTS
Radiology
RADIOLOGY AND NUCLEAR MEDICINE
Review
SURGERY
Syndrome
Ulcer - complications
Ulcer - diagnostic imaging
ULCERS
Ultrasound
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Description
Summary:Acute aortic syndromes include a variety of overlapping clinical and anatomic diseases. Penetrating aortic ulcer (PAU), intramural hematoma (IMH) and aortic dissection can occur as isolated processes or can be found in association. All these entities are potentially life threatening, so prompt diagnosis and treatment is of paramount importance. PAU and IMH lesions in the Stanford Type A distribution often require urgent open surgical repair. Lesions in the Stanford Type B distribution may be managed medically in the absence of symptoms or progression; however, a low threshold for endovascular or surgical treatment should be maintained. This review summarizes the clinical presentation, epidemiology, diagnosis, indications for treatment and endovascular strategies in patients with PAU or IMH.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-018-2114-x