Endovascular Repair of the Descending Thoracic Aorta for Penetrating Atherosclerotic Ulcer Disease

The pathological variants of acute aortic syndromes include classic dissection, intramural hematomas, and penetrating atherosclerotic ulcers (PAUs). The subject of the appropriate management and treatment of PAUs continues to expand as this disease entity is increasingly identified. The application of thoracic endografting, or thoracic endovascular aortic repair (TEVAR), to treat these acute aortic pathologies is clearly evolving and the ultimate effectiveness and durability of thoracic endografting remains to be determined as clinical experience increases. The disease pathology of PAUs and the use of endovascular stent graft placement in PAU disease are closely examined in this manuscript.