Acute Type B Penetrating Aortic Ulcer with Imaging Signs of Rupture, Refractory Pain, or Refractory Hypertension
This protocol addresses the acute complicated presentation of type B penetrating aortic ulcer — a high-risk scenario defined by specific imaging and clinical criteria that indicate the need for urgent management.
Complicated PAUs are identified at presentation by imaging signs of rupture, refractory pain, or refractory hypertension. This combination of findings characterises the acute complicated presentation and carries implications for the timing and type of intervention.
Management centres on thoracic endovascular aortic repair (TEVAR) in the acute setting. The full protocol specifies the detailed technical requirements for endograft selection, sealing zone configuration, and anatomical considerations — only the complete structured regimen covers these in full.
References
DOI: 10.1016/j.ejvs.2025.09.045
- At presentation, complicated PAUs are identified by the presence of imaging signs of rupture, or refractory pain, or refractory hypertension (grade B).
- Acute complicated PAU/IMH should be treated in the acute setting.