title: Percutaneous pulmonary vein stenting for the treatment of severe stenosis after pulmonary vein isolation.
abstract: BACKGROUND
  Pulmonary vein stenosis (PVS) is a potential complication of pulmonary vein isolation (PVI) using radiofrequency energy. The aim of our study was the evaluation of the severity and long-term outcome of primary angioplasty and angioplasty with pulmonary vein stenting for PVS.
  
  
  RESULTS
  Twelve patients with 15 PVS (greater than 70% stenosis) were prospectively evaluated. Primary dilation of the stenosis was performed because of clinical symptoms (10 patients) and/or the lung perfusion scans showed a significant perfusion defect (11 patients). Magnetic resonance imaging and lung perfusion scans performed before, directly after, during 3-month, and 6-month follow-up. In the stenting group additional multislice CT-scans directly after, during 6-month, and 12-month follow-up were performed. Within 2 months after primary balloon angioplasty, the PV size parameters were significantly reduced (P < 0.001) with recurrence of PVS in 11 of 15 PVs (73%). Pulmonary vein stenting in 8 patients and 11 PVs resulted in no vein stenosis during 12-month follow-up. Normalization of lung perfusion was noted in 8 of 12 patients. We observed 2 patients with hemoptysis during PV dilation, as severe complications with potential life-threatening character.
  
  
  CONCLUSIONS
  PVS stenting seems to be superior to balloon angioplasty and effective at least over a period of 12 months in treating acquired PVS after pulmonary vein isolation.
authors.affiliation: Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. TNeuman1@aol.com
authors.forename: Thomas
authors.initials: T
authors.lastname: Neumann
authors.forename: Johannes
authors.initials: J
authors.lastname: Sperzel
authors.forename: Thorsten
authors.initials: T
authors.lastname: Dill
authors.forename: Alexander
authors.initials: A
authors.lastname: Kluge
authors.forename: Ali
authors.initials: A
authors.lastname: Erdogan
authors.forename: Harald
authors.initials: H
authors.lastname: Greis
authors.forename: Jochen
authors.initials: J
authors.lastname: Hansel
authors.forename: Alexander
authors.initials: A
authors.lastname: Berkowitsch
authors.forename: Klaus
authors.initials: K
authors.lastname: Kurzidim
authors.forename: Malte
authors.initials: M
authors.lastname: Kuniss
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
authors.forename: Heinz-F
authors.initials: HF
authors.lastname: Pitschner
mesh_terms: D000800:Angioplasty, Balloon; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000473:pathology* / Q000601:surgery; D011668:Pulmonary Veno-Occlusive Disease / Q000209:etiology / Q000601:surgery*; D018709:Statistics, Nonparametric; D015607:Stents; D014057:Tomography, X-Ray Computed