{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:24:40Z","timestamp":1792607080124,"version":"4.5.0"},"reference-count":17,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T00:00:00Z","timestamp":1649980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Penetrating aortic ulceration (PAU) is an acute aortic syndrome similar to aortic dissection and intramural hematoma. It is the result of a tunica intima ulceration due to atherosclerotic disease. This clinical condition can lead to serious complications and a poor short-term prognosis, especially in high-surgical-risk patients. We report three cases of patients referred to \u201cOspedale del Cuore\u201d of Massa (Italy) with PAU at the aortic arch-proximal descending aorta level who could not undergo surgical intervention. For the first time in Italy, we successfully treated these patients with a full percutaneous implantation of a Castor branched aortic stent graft. Our case series shows that this type of endovascular graft is an effective, safe, and feasible treatment for PAU involving a distal aortic arch and avoiding surgery and related complications.<\/jats:p>","DOI":"10.3390\/ijerph19084809","type":"journal-article","created":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T07:42:41Z","timestamp":1650094961000},"page":"4809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Penetrating Aortic Ulceration Treated with Castor Branched Aortic Stent Graft\u2014A Case Series"],"prefix":"10.3390","volume":"19","author":[{"given":"Antonio","family":"Rizza","sequence":"first","affiliation":[{"name":"Cardiology Unit, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3744-031X","authenticated-orcid":false,"given":"Francesco","family":"Negro","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Palermi","sequence":"additional","affiliation":[{"name":"Human Anatomy and Sport Medicine Division, Department of Public Health, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cataldo","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Murzi","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, G. Pasquinucci Heart Hospital, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Credi","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Hospital of Massa Carrara, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Berti","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0890-5096(06)60697-3","article-title":"Penetrating atherosclerotic ulcers of the thoracic aorta: Natural history and clinicopathologic correlations","volume":"1","author":"Stanson","year":"1986","journal-title":"Ann. Vasc. 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