Percutaneous Transluminal Stenting of Infra-Renal Abdominal Aorta Penetrating Atherosclerotic Ulcer

Abstract

Predominantly found in the descending thoracic aorta, Penetrating Atherosclerotic Ulcer (PAU) is uncommon in the infra-renal abdominal aorta. It is defined as atherosclerotic lesions with ulceration of the aortic intima and media, and rupture of the internal elastic lamina. PAU is considered as a rare serious clinical entity that may induce aortic dissection, aortic rupture, and secular aortic aneurysm typically occurs in elderly hypertensive patients with severe systemic atherosclerosis disease. The treatment of PAU remains a subject of considerable controversy. With the development of percutaneous techniques of stent placement, stenting has emerged as a new option in the treatment of abdominal aorta PAU. We report a 68 years old man with PAU being diagnosed with symptoms of intermittent claudication of both lower limbs; that underwent intraluminal stenting. The technical success rate was 100%. We obtained excellent short and medium term clinical success without finding any complications related. Although open surgical repair is an effective therapeutic option, endovascular treatment of abdominal aortic PAU is a safe attractive alternative to surgery therapy that should be considered as the treatment of choice. Keywords: Claudication penetrating atherosclerotic ulcer; Angioplasty; Palmaz stent; Abdominal aorta