Endovascular stent-graft repair for penetrating atherosclerotic ulcer in the infrarenal abdominal aorta Yoshihiko Tsuji, MD, Yosuke Tanaka, MD, Atsushi.

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Endovascular stent-graft repair for penetrating atherosclerotic ulcer in the infrarenal abdominal aorta Yoshihiko Tsuji, MD, Yosuke Tanaka, MD, Atsushi Kitagawa, MD, Yutaka Hino, MD, Takanori Taniguchi, MD, Koji Sugimoto, MD, Hitoshi Matsuda, MD, Yutaka Okita, MD Journal of Vascular Surgery Volume 38, Issue 2, Pages 383-388 (August 2003) DOI: 10.1016/S0741-5214(03)00139-3

Fig 1 Schema of clinical course of penetrating atherosclerotic ulcer of the aorta. This lesion may lead to aortic intramural hematoma, adventitial pseudoaneurysm, and rupture with extra-aortic hematoma. Calcified plaques detected on plain CT scans are useful markers for differential diagnosis of intramural hematoma and intraluminal thrombus, and true aneurysm and adventitial pseudoaneurysm. Journal of Vascular Surgery 2003 38, 383-388DOI: (10.1016/S0741-5214(03)00139-3)

Fig 2 Patient 1. Penetrating atherosclerotic ulcer in the abdominal aorta, with intramural hematoma. A, Preoperative contrast-enhanced CT scan. B, Preoperative aortogram shows localized contrast-filled outpouching in the infrarenal aorta. C, Aortogram after deployment of the stent graft demonstrates that the lesion has been completely sealed. Journal of Vascular Surgery 2003 38, 383-388DOI: (10.1016/S0741-5214(03)00139-3)

Fig. 3 Patient 2. Penetrating atherosclerotic ulceration in the abdominal aorta with pseudoaneurysm. A, Preoperative contrast-enhanced CT scan. B, Contrast-enhanced CT scan obtained 8 days after endovascular stent grafting demonstrates complete exclusion of the lesion and the adventitial pseudoaneurysm. Journal of Vascular Surgery 2003 38, 383-388DOI: (10.1016/S0741-5214(03)00139-3)

Fig. 4 Patient 4. Penetrating atherosclerotic ulceration in the abdominal aorta with extra-aortic hematoma. A, Preoperative contrast-enhanced CT scan. B, Preoperative aortogram shows contrast-filled protrusion in the infrarenal shaggy aorta. Journal of Vascular Surgery 2003 38, 383-388DOI: (10.1016/S0741-5214(03)00139-3)