{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T22:44:41Z","timestamp":1777848281589,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Introduction and objectives:<\/jats:title>\n                    <jats:p>Thoracic penetrating aortic ulcers are an infrequent, but potentially serious entity, and its treatment is still controversial. This study presents the long-term results of the endovascular treatment for penetrating ulcers of the thoracic aorta.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between 1998 and 2023, 42 patients diagnosed with thoracic penetrating aortic ulcers were treated with endografts at a tertiary care hospital. Preoperative, intraoperative, and follow-up complications and mortality data were collected and analyzed. Survival rates during follow-up were estimated using Kaplan-Meier curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Treatment was indicated for symptomatic cases in 14 patients (33.3%), most of whom presented with thoracic or dorsal pain, 1 with distal embolization, and 2 with aortic rupture. Standard thoracic endografts were used in 38 cases (90%), while branched\/scalloped and\/or fenestrated endografts were employed in 4 cases, with an average of 1.2 endografts per patient. Eight cases (19%) required prior revascularization of supra-aortic trunks. Technical success was 100%, with no intraoperative deaths or open conversions. In-hospital medical complications occurred in 16.6% of patients, and the 30-day cumulative mortality rate was 4.7%. After a mean follow-up of 71.7 months (range: 0.1\u2013283 months), the endoleak rate was 19% and the cumulative 5-year reintervention-free survival rate was 80.6%. The overall survival rates at 1, 5, and 10 years were 87.4%, 77.5%, and 60.5%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Endovascular treatment for penetrating ulcers of the thoracic aorta demonstrates favorable short and long-term outcomes, with high technical success and low aorta\/procedure related mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>This study reinforces TEVAR as a safe and effective first-line therapy for penetrating aortic ulcers, offering clinicians strong long-term data to support decision-making in a high-risk, elderly population. The findings underscore that most PAUs can be treated with limited aortic coverage and minimal adjunctive procedures, reducing procedural complexity and morbidity. The extended follow-up\u2014among the longest reported\u2014highlights durable aortic exclusion, while emphasizing the importance of lifelong imaging due to endoleak-related reinterventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028251398967","type":"journal-article","created":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T05:43:07Z","timestamp":1766814187000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mid and Long-term Results of Endovascular Treatment of Thoracic Penetrating Aortic Ulcers"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6141-0279","authenticated-orcid":false,"given":"Victoria","family":"Gam\u00e9","sequence":"first","affiliation":[{"name":"Vascular Surgery Department, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8699-7037","authenticated-orcid":false,"given":"Gaspar","family":"Mestres","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Ravent\u00f3s","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2244-7415","authenticated-orcid":false,"given":"Fabricio","family":"Barahona","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5672-8995","authenticated-orcid":false,"given":"Adri\u00e1n","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicente","family":"Riambau","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Hospital Cl\u00ednic de Barcelona, Barcelona, 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