Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations

doi:10.1016/S0890-5096(06)60697-3

Annals of Vascular Surgery

Volume 1, Issue 1, May 1986, Pages 15-23

https://doi.org/10.1016/S0890-5096(06)60697-3 Get rights and content

Clinically, penetrating atheromatous ulceration of the aortic wall may be confused with either symptomatic thoracic aneurysm or classic spontaneous aortic dissection. Aortography and computed tomographic (CT) scanning of the thoracic aorta provide specific diagnostic information which permits one to distinguish this lesion from atherosclerotic aneurysm and classic dissection. Hallmarks of findings on aortography and CT scan include the presence of the ulcer and an intramural hematoma. Since the findings may be disarmingly subtle, the potentially progressive and serious nature of this condition may remain unappreciated. Recognition of the penetrating atheromatous ulcer and distinguishing it from aortic dissection arising just distal to the origin of the left subclavian artery is mandatory. Resection of only a conservative segment of the proximal descending aorta suffices for classic dissection in the upper descending thoracic aorta, but the penetrating aortic ulcer requires graft replacement in the area of the ulcer and intramural hematoma.

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Presented at the Eighth annual meeting of the Midwestern Vascular Surgical Society, Columbus, OH, September 21 and 22, 1984.

Reprint requests: F.J. Kazmier MD, Division of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905.

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Original articlesPenetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations

Am Heart J

Am J Cordial

Am J Med

Spontaneous laceration of ascending aorta

Circulation

Pathogenesis of dissecting aneurysm of aorta: comparative histopathologic study of significance of medial changes

Am J Cardiol

Aortic dissecting aneurysms: causative factors in 204 subjects

Arch Pathol Lab Med

Dissecting aneurysm of the aorta

Cardiovasc Clin

Original articles
Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations