Imperial College London
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Professor Mohamad Hamady

Faculty of Medicine, Department of Surgery & Cancer

Professor of Practice (Interventional Radiology)
 
 
 
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Contact

 

+44 (0)20 3312 2282 1m.hamady

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Salim:2020:10.1016/j.jvs.2019.09.039,
author = {Salim, S and Locci, R and Martin, G and Gibbs, R and Jenkins, M and Hamady, M and Riga, C and Bicknell, C and Imperial, Vascular Unit Collaborators},
doi = {10.1016/j.jvs.2019.09.039},
journal = {Journal of Vascular Surgery},
pages = {84--91},
title = {Short- and long-term outcomes in isolated penetrating aortic ulcer disease},
url = {http://dx.doi.org/10.1016/j.jvs.2019.09.039},
volume = {72},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: The optimum management of isolated penetrating aortic ulceration (PAU), with no associated intramural hematoma or aortic dissection is not clear. We evaluate the short- and long-term outcomes in isolated PAU to better inform management strategies. METHODS: We conducted a retrospective review of 43 consecutive patients (mean age, 72.2 years; 26 men) with isolated PAU (excluding intramural hematoma/aortic dissection) managed at a single tertiary vascular unit between November 2007 and April 2019. Twenty-one percent had PAU of the arch, 62% of the thoracic aorta, and 17% of the abdominal aorta. Conservative and surgical groups were analyzed separately. Primary outcomes included mortality, PAU progression, and interventional complications. RESULTS: Initially, 67% of patients (29/43) were managed conservatively; they had significantly smaller PAU neck widths (P = .04), PAU depths (P = .004), and lower rates of associated aneurysmal change (P = .004) compared with those initially requiring surgery. Four patients (4/29) initially managed conservatively eventually required surgical management at a mean time interval of 49.75 months (range, 9.03-104.33 months) primarily owing to aneurysmal degeneration. Initially, 33% of patients (14/43) underwent surgical management; 7 of the 14 procedures were urgent. Of the 18 patients, 17 eventually managed with surgical intervention had an endovascular repair; 2 of the 17 endovascular cases involved supra-aortic debranching, six used scalloped, fenestrated, or chimney stents. The overall long-term mortality was 30% (mean follow-up, 48 months; range, 0-136 months) with no significant difference between the conservatively and surgically managed groups (P = .98). No aortic-related deaths were documented during follow-up in those managed conservatively. There was no in-hospital mortality after surgical repair. Of these 18 patients, two required reintervention within 30 days for t
AU  - Salim,S
AU  - Locci,R
AU  - Martin,G
AU  - Gibbs,R
AU  - Jenkins,M
AU  - Hamady,M
AU  - Riga,C
AU  - Bicknell,C
AU  - Imperial,Vascular Unit Collaborators
DO  - 10.1016/j.jvs.2019.09.039
EP  - 91
PY  - 2020///
SN  - 0741-5214
SP  - 84
TI  - Short- and long-term outcomes in isolated penetrating aortic ulcer disease
T2  - Journal of Vascular Surgery
UR  - http://dx.doi.org/10.1016/j.jvs.2019.09.039
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32089340
UR  - https://www.sciencedirect.com/science/article/pii/S0741521419325017?via%3Dihub
UR  - http://hdl.handle.net/10044/1/77217
VL  - 72
ER  -
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