{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T01:50:54Z","timestamp":1789264254457,"version":"build-2803163510"},"reference-count":43,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2015,10,28]],"date-time":"2015-10-28T00:00:00Z","timestamp":1445990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:p>Purpose: To analyze an 11-year single-center experience of treating complicated penetrating aortic ulcer (PAU) using thoracic endovascular aortic repair (TEVAR). Methods: This study included 63 consecutive patients (mean age 69.1\u00b111.5 years; 40 men) with complicated PAU (42 symptomatic, 22 with rupture) who underwent TEVAR between 2002 and 2013. The PAUs were located in the aortic arch (n=11), the descending thoracic aorta (n=43), and the thoracoabdominal aorta (n=9). Results: TEVAR was performed within 14 days of diagnosis in 33 (52.3%) cases (19 ruptures treated immediately); the other 30 (47.6%) patients had an average interval between diagnosis and intervention of 40\u00b139 days. Technical success was 98.4% (62\/63). One patient had a type I endoleak after stent-graft repair of a PAU in the aortic arch without great vessel transposition; another procedure was required for carotid-subclavian bypass and proximal stent-graft extension. No patient experienced spinal cord ischemia after TEVAR. Five (7.9%) patients died in-hospital; 3 had severe cardiac complications, 1 died from complications of aortic rupture, and the other succumbed to septic shock. Mean follow-up was 45.6\u00b147.2 months, during which 12 (19.0%) patients needed a secondary intervention because of late endoleaks (n=4, 6.3%) or new complications due to disease progression. Multivariate analysis indicated that a PAU depth &gt;15 mm was an independent predictor of mortality (hazard ratio 6.92, p=0.03). In the biomarker analysis, symptomatic patients had significantly higher D-dimer and troponin levels compared to asymptomatic patients [559.5\u00b1460.7 vs 283.2\u00b185.2 \u00b5g\/L (p=0.016) and 0.22\u00b10.61 vs 0.02\u00b10.03 ng\/mL (p=0.04), respectively]. Conclusion: Patients with PAU suffer from underlying severe atherosclerotic disease and have a significant number of cardiovascular comorbidities that lead to relevant mortality and morbidity after TEVAR. As a PAU diameter &gt;15 mm represented high risk for disease progression, these patients may be candidates for early intervention. D-dimer levels may help identify patients at risk and with progression of PAU.<\/jats:p>","DOI":"10.1177\/1526602815613790","type":"journal-article","created":{"date-parts":[[2015,12,26]],"date-time":"2015-12-26T11:17:27Z","timestamp":1451128647000},"page":"150-159","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":39,"title":["Thoracic Endovascular Repair of Complicated Penetrating Aortic Ulcer"],"prefix":"10.1177","volume":"23","author":[{"given":"Rolf Alexander","family":"J\u00e1nosi","sequence":"first","affiliation":[{"name":"Department of Cardiology, West-German Heart and Vascular Center Essen and University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Gorla","sequence":"additional","affiliation":[{"name":"Department of Cardiology, West-German Heart and Vascular Center Essen and University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Tsagakis","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen and University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Kahlert","sequence":"additional","affiliation":[{"name":"Department of Cardiology, West-German Heart and Vascular Center Essen and University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Horacek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, West-German Heart and Vascular Center Essen and University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Bruckschen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, West-German Heart and Vascular Center Essen and University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel-Sebastian","family":"Dohle","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen and University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Jakob","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen and University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Eggebrecht","sequence":"additional","affiliation":[{"name":"Cardioangiological Center Bethanien (CCB), Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Bossone","sequence":"additional","affiliation":[{"name":"Heart Department, University Hospital, Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimund","family":"Erbel","sequence":"additional","affiliation":[{"name":"Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,10,28]]},"reference":[{"key":"bibr1-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2001.2782"},{"key":"bibr2-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu281"},{"key":"bibr3-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/S0890-5096(06)60697-3"},{"key":"bibr4-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(98)70003-5"},{"key":"bibr5-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2002.121681"},{"key":"bibr6-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.01837.x"},{"key":"bibr7-1526602815613790","unstructured":"Erbel R, Aboyans V, Boileau C, et al, Web addenda to the 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. http:\/\/www.escardio.org\/static_file\/Escardio\/Guidelines\/publications\/ADAortic_2014_Web_Addenda.pdf. Accessed October 10, 2015."},{"key":"bibr8-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.12.054"},{"key":"bibr9-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(03)00173-5"},{"key":"bibr10-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1097\/00001573-200311000-00002"},{"key":"bibr11-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.10.099"},{"key":"bibr12-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1583\/08-2497.1"},{"key":"bibr13-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-007-0832-6"},{"key":"bibr14-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1080\/13645700902920833"},{"key":"bibr15-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.05.020"},{"key":"bibr16-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezs287"},{"key":"bibr17-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1517\/17530059.2012.704362"},{"key":"bibr18-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(99)00134-7"},{"key":"bibr19-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1177\/1526602815584925"},{"key":"bibr20-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.123763"},{"key":"bibr21-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25614"},{"key":"bibr22-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00194-6"},{"key":"bibr23-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2008.00660.x"},{"key":"bibr24-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000022164.26075.5A"},{"key":"bibr25-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.02.087"},{"key":"bibr26-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.03.074"},{"key":"bibr27-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.02.043"},{"key":"bibr28-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.08.005"},{"key":"bibr29-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.11.050"},{"key":"bibr30-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.759076"},{"key":"bibr31-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.835926"},{"key":"bibr32-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25758"},{"key":"bibr33-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.05.121"},{"key":"bibr34-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu386"},{"key":"bibr35-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1583\/10-3063.1"},{"key":"bibr36-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.07.058"},{"key":"bibr37-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(94)70124-5"},{"key":"bibr38-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2006.08.073"},{"key":"bibr39-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1007\/s00059-011-3513-9"},{"key":"bibr40-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00816-6"},{"key":"bibr41-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.05.043"},{"key":"bibr42-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2007.02.025"},{"key":"bibr43-1526602815613790","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.10.079"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526602815613790","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1526602815613790","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526602815613790","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:29:32Z","timestamp":1777498172000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1526602815613790"}},"subtitle":["An 11-Year Single-Center Experience"],"short-title":[],"issued":{"date-parts":[[2015,10,28]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1177\/1526602815613790"],"URL":"https:\/\/doi.org\/10.1177\/1526602815613790","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,28]]}}}