Risk factors for penetrating aortic ulcer progression

Objectives: This study aimed to explore risk factors leading to asymptomatic penetrating aortic ulcer (PAU) progression.

Methods: This retrospective study reviewed the clinical data of patients who were diagnosed with asymptomatic PAU through incidental imaging findings and underwent imaging follow-up between August 2018 and July 2022. Patients were grouped according to ulcer progression. The risk factors for PAU progression were also analyzed.

Results: Among 60 patients with PAU, 32 (53.33%) experienced PAU progression. The mean follow-up time was 555.72±407.60 days. Although there was no statistically significant difference in cancer incidence between the PAU progression group and non-progression group (24 [75%] vs. 18 [64.28%], p=0.409), the difference in antineoplastic therapy use between the progression and non-progression groups was significant (19 [59.38%] vs. 7 [25.00%], p=0.010). There was no difference in the aortic diameter at the PAU (20.68±4.16 mm vs. 20.70±5.28 mm, p=0.990), PAU width (7.32±2.53 mm vs. 7.11±2.29 mm, p=0.741), and PAU depth (4.13±1.26 mm vs. 4.08±1.41 mm, p=0.880) between the two groups. In the progression group, the progression rates of aortic diameter at PAU, PAU width, and PAU depth were 2.16±4.28 mm/year, 5.91±14.49 mm/year and 2.87±5.87 mm/year, respectively. Binary logistic regression analysis showed that antineoplastic therapy was an independent predictor of PAU progression (p=0.017; OR, 4.144; 95% CI, 1.290-13.316).

Conclusions: Antineoplastic therapy may contribute to the progression of asymptomatic PAU in this retrospective study with small number of patients. Patients with asymptomatic PAU who are receiving or have completed antineoplastic therapy should be more vigilant regarding PAU progression.