Penetrating Aortic Ulcer and Intramural Hematoma

Gustavo S. Oderich, Jussi M. Kärkkäinen, Nanette R. Reed, Emanuel R. Tenorio, Giuliano A. Sandri

Research output: Contribution to journalReview articlepeer-review

69 Scopus citations


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.

Original languageEnglish
Pages (from-to)321-334
Number of pages14
JournalCardiovascular and Interventional Radiology
Issue number3
StatePublished - Mar 15 2019


  • Acute aortic syndrome
  • Intramural hematoma
  • Penetrating aortic ulcer


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