Penetrating atherosclerotic ulcer

A penetrating atherosclerotic ulcer (PAU) is an atherosclerotic lesion that ulcerates, leading to a hematoma forming within the walls of the aorta.cite journal |author=Hayashi H, Matsuoka Y, Sakamoto I, "et al" |title=Penetrating atherosclerotic ulcer of the aorta: imaging features and disease concept |journal=Radiographics |volume=20 |issue=4 |pages=995–1005 |year=2000 |pmid=10903689 |doi= |url=http://radiographics.rsnajnls.org/cgi/content/full/20/4/995 | accessdate = 2008-05-26 ]

Diagnosis

The condition is often associated with thickening of the aortic wall, and can be differentiated from similar conditions (atherosclerotic plaque and a thrombus) through the use of computed tomography and magnetic resonance imaging, though the latter is superior.cite journal | last=Chu | first=B | coauthors= Yuan C, Takaya N et al. | title=Serial high-spatial-resolution, multisequence magnetic resonance imaging studies identify fibrous cap rupture and penetrating ulcer into carotid atherosclerotic plaque | journal=Circulation | publisher=American Heart Association | volume=113 | issue=12 | pages=e660–e661 | date=March 2006 | pmid=16567574 | url=http://circ.ahajournals.org/cgi/content/full/113/12/e660 | doi=10.1161/CIRCULATIONAHA.105.567255 | accessdate=2008-05-28 ] Transesophageal echocardiography and intravascular ultrasonography may also be used in differentiation.

Treatment

Complications such as rupture or other life-threatening conditions are rare. Treatment may involve surgery, particularly when signs indicating worsening are present (the patient is unable to control their pain or changes in blood pressure).

Notes