Penetrating atherosclerotic ulcers of the aorta

Background: Penetrating aortic ulcers burrow into the aortic wall and can h ave fatal consequences. Although they were first described as long ago as 1 934 they have only recently been recognized as a distinct pathological enti ty. Method: A review of the current literature was undertaken, based primarily on an English language Medline search with secondary references obtained fr om key articles. Results: Penetrating aortic ulcer is principally a disease of elderly hyper tensive men. It may run a benign course or may produce complications such a s aortic rupture, embolization and aneurysm formation. Presentation may be identical to that of classical aortic dissection, but the distinction is im portant because an ulcer may be more likely to cause rupture. Conclusion: Open surgical repair has been the 'gold standard' of treatment but endovascular stenting is an attractive option in this group of frail pa tients.