Evaluation of the results of penetrating atherosclerotic ulcers surgical treatment

Abstract

INTRODUCTION: Penetrating atherosclerotic ulcers (PAU) are a rare disease, but their complications may lead to the patient’s decease. The development of diagnostic imaging techniques enables its more accurate detection, while the progress in the field of endovascular surgery possibilities safe and efficient treatment. The aim of the present paper is to assess PAU treatment results regarding patients treated at the Department of General, Vascular and Transplant Surgery, Medical University of Warsaw in the years 2006–2011.

MATERIAL AND METHODS: Documentation on 28 patients (22 men and 6 women) has been subjected to retrospective analysis. The average patient age was 68. Twenty six of the diseased were treated by means of stentgraft implantation. One patient underwent an open repair with aortic replacement and conventional tube graft positioning. Combined thoracic stentgraft implantation and open repair of infrarenal aortic PAU with bifurcated bypass were performed in another patient. The average follow-up was of 27 months. Over that period of time three cases of complications requiring re-intervening were detected: stentgraft limb thrombosis, endoleak type IB and type II.

RESULTS: All of the complications were effectively treated by endovascular interventions. Neither surgery-related deaths, nor spinal cord ischemia symptoms were observed.

CONCLUSIONS: Based on the investigated material, it is safe to say that stentgraft implantation PAU treatment is an effective method, but it is required that guidelines regarding clinical procedure are defined.