Endovascular stents for treatment of coarctation of the aorta: acute results and follow-up experience.
Balloon angioplasty as treatment for coarctation of the aorta is increasingly performed. Endovascular stents have been proposed as a means of improving the efficacy and safety of the procedure. In this report, we describe one institution's immediate results and clinical follow-up after implantation of endovascular stents. Retrospective analysis for endovascular stent placement for coarctation of the aorta between 1993 and 2002 was made. The immediate hemodynamic results and clinical follow-up were reviewed. Thirty-two patients underwent attempted stent placement for coarctation. Twenty-three patients had postoperative recurrent coarctation and nine had native coarctation. The systolic gradient decreased from 31 to 1.8 mm Hg (P = 0.001) and the diameter was increased 8.1 to 13.5 mm (P-0.001). Mean follow-up was 1.5 years. The mean follow-up gradient as assessed by sphygomomanometry was 13.1 mm Hg. Eight patients underwent 10 successful further dilations. Complications included one stent migration and one aortic dissection. The use of stents as an adjunct to balloon angioplasty in selected patients with coarctation can be performed with low complication rates and provides excellent immediate relief of obstruction with promising follow-up. Further dilation of these stents is possible. Long-term follow-up is warranted.
Johnston
Troy A
TA
Division of Pediatric Cardiology, Department of Pediatrics, University of Washington and Children's Hospital and Regional Medical Center, Seattle, Washington, USA. troy.johnston@seattlechildrens.org
Grifka
Ronald G
RG
Jones
Thomas K
TK
D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001027:Aortography; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D019722:Sphygmomanometers; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome