title: Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta.
abstract: BACKGROUND
  We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques.
  
  
  RESULTS
  Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005. About 27% (160/588) procedures were followed up by further IAI of their aorta (MRI/CT/repeat cardiac catheterization) after initial stent procedures. Abnormal imaging studies included: the presence of dissection or aneurysm formation, stent fracture, or the presence of reobstruction within the stent (instent restenosis or significant intimal build-up within the stent). Forty-one abnormal imaging studies were reported in the intermediate follow-up at median 12 months (0.5-92 months). Smaller postintervention of the aorta (CoA) diameter and an increased persistent systolic pressure gradient were associated with encountering abnormal follow-up imaging studies. Aortic wall abnormalities included dissections (n = 5) and aneurysm (n = 13). The risk of encountering aortic wall abnormalities increased with larger percent increase in CoA diameter poststent implant, increasing balloon/coarc ratio, and performing prestent angioplasty. Stent restenosis was observed in 5/6 parts encountering stent fracture and neointimal buildup (n = 16). Small CoA diameter poststent implant and increased poststent residual pressure gradient increased the likelihood of encountering instent restenosis at intermediate follow-up.
  
  
  CONCLUSIONS
  Abnormalities were observed at intermediate follow-up following IS placement for treatment of native and recurrent coarctation of the aorta. Not exceeding a balloon:coarctation ratio of 3.5 and avoidance of prestent angioplasty decreased the likelihood of encountering an abnormal follow-up imaging study in patients undergoing intravascular stent placement for the treatment of coarctation of the aorta. We recommend IAI for all patients undergoing IS placement for treatment of CoA.
authors: Children's Hospital of Michigan, Wayne State University, Detroit, Michigan, USA. tforbes@dmc.org
authors: Thomas J
authors: TJ
authors: Forbes
authors: Phillip
authors: P
authors: Moore
authors: Carlos A C
authors: CA
authors: Pedra
authors: Evan M
authors: EM
authors: Zahn
authors: David
authors: D
authors: Nykanen
authors: Zahid
authors: Z
authors: Amin
authors: Swati
authors: S
authors: Garekar
authors: David
authors: D
authors: Teitel
authors: Shakeel A
authors: SA
authors: Qureshi
authors: John P
authors: JP
authors: Cheatham
authors: Makram R
authors: MR
authors: Ebeid
authors: Ziyad M
authors: ZM
authors: Hijazi
authors: Satinder
authors: S
authors: Sandhu
authors: Donald J
authors: DJ
authors: Hagler
authors: Horst
authors: H
authors: Sievert
authors: Thomas E
authors: TE
authors: Fagan
authors: Jeremy
authors: J
authors: Ringwald
authors: Wei
authors: W
authors: Du
authors: Liwen
authors: L
authors: Tang
authors: David F
authors: DF
authors: Wax
authors: John
authors: J
authors: Rhodes
authors: Troy A
authors: TA
authors: Johnston
authors: Thomas K
authors: TK
authors: Jones
authors: Daniel R
authors: DR
authors: Turner
authors: Robert
authors: R
authors: Pass
authors: Alejandro
authors: A
authors: Torres
authors: William E
authors: WE
authors: Hellenbrand
mesh_terms: D000293:Adolescent; D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D001027:Aortography / Q000379:methods*; D001938:Brazil; D006328:Cardiac Catheterization; D002648:Child; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D005060:Europe; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D017410:Practice Guidelines as Topic; D011475:Prosthesis Failure; D012107:Research Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014481:United States