When acute type B penetrating aortic ulcer (PAU) presents without rupture, without refractory pain, and without refractory hypertension, it falls into the uncomplicated category — a distinct clinical situation that calls for a specific, guideline-supported management pathway.
Clinical scenario: Acute type B penetrating aortic ulcer without rupture, without refractory pain, and without refractory hypertension. The absence of high-risk features defines this presentation as uncomplicated and directly shapes the recommended approach.
In this uncomplicated setting, a conservative management strategy is indicated — along with structured serial radiological surveillance to monitor disease progression. The complete imaging schedule, escalation criteria, and full protocol detail are available via the link below.
DOI: 10.1016/j.ejvs.2025.09.045
Uncomplicated IMH/PAU should be managed conservatively and followed with serial computed tomography imaging during the acute phase.
TEVAR is not indicated in patients with uncomplicated acute type B PAU/IMH without high risk features (statement 16, grade A).
Uncomplicated PAU/IMH should be managed with a conservative approach and followed with CTA performed at two, seven, and 14 days after onset.
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