Thoracic Endovascular Aortic Repair of a Penetrating Aortic Ulcer in the Thoracic Aorta Combined with an Abdominal Aortic Aneurysm

Abstract

Penetrating aortic ulcers (PAUs) are part of acute aortic syndrome and can cause aortic rupture. We report a case of abdominal aortic aneurysm (AAA) with a PAU in the thoracic aorta. The patient was treated with thoracic aortic endovascular repair (TEVAR) for the PAU and open repair for the AAA. A 78-year-old man was admitted due to abdominal discomfort. Computed tomography (CT) showed a 6.8-cm AAA with a short neck and a large (4.2 × 3.3 cm) thoracic PAU. The patient was scheduled for AAA repair. Due to the risk of rupture of the thoracic PAU, TEVAR was performed in the PAU before surgery for the AAA. After stent graft insertion, the patient underwent surgery to repair the AAA. A follow-up CT scan showed no endoleakage or thrombus formation in the PAU. The patient had no specific symptoms during 1 year of follow-up. (Korean J Med 2012;82:481-486)