title: Balloon expandable stent implantation for native and recurrent coarctation of the aorta--prospective computed tomography assessment of stent integrity, aneurysm formation and stenosis relief.
abstract: BACKGROUND
  Stenting for aortic coarctation is known to be effective in the medium term. Aneurysm formation following stent implantation is a recognised complication. However, data regarding aortic wall injury and stent integrity following stent placement are sparse.
  
  
  OBJECTIVE
  We report comprehensive clinical, echocardiographic and prospective CT follow-up data following stenting for aortic coarctation from a single centre. Methods Full data analysis of all patients undergoing balloon expandable stent implantation and follow-up procedures in a single tertiary congenital cardiac unit.
  
  
  RESULTS
  Between October 2002 and April 2008, we performed 102 coarctation stent procedures on 88 patients. Median age was 20.6 years (range 8.5-65) and median weight 65 kg (range 34-101). 94 stents (26 covered) were implanted. 12 procedures were re-dilatations. Stenting resulted in a reduction of the gradient across the site of coarctation, from a median of 20 mm Hg to 4 mm Hg. There were no procedure-related deaths. Four patients had immediate complications (one requiring emergency surgery). During median follow-up of 34.5 months (range 4.2-72.8), two patients had late complications requiring additional stent procedures. Follow-up CT data are available in 84 patients with MRI in one patient (96.5%). Only one patient developed a procedure-related aortic aneurysm. All stent fractures (n=7) occurred with a single stent design.
  
  
  CONCLUSIONS
  Stenting for aortic coarctation and re-coarctation is effective with low immediate complication rates. CT is useful in the longer term for assessment of stent integrity and post-procedural aneurysm formation. Overall incidence of post-procedural aneurysm is rare and stent fractures were not seen with newer generation stents.
authors.affiliation: Bristol Congenital Heart Centre, Bristol Royal Hospital for Children and Bristol Royal Infirmary, Bristol, UK.
authors.forename: Santabhanu
authors.initials: S
authors.lastname: Chakrabarti
authors.forename: Damien
authors.initials: D
authors.lastname: Kenny
authors.forename: Gareth
authors.initials: G
authors.lastname: Morgan
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Curtis
authors.forename: Mark C K
authors.initials: MC
authors.lastname: Hamilton
authors.forename: Peter
authors.initials: P
authors.lastname: Wilde
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Tometzki
authors.forename: Mark S
authors.initials: MS
authors.lastname: Turner
authors.forename: Robin P
authors.initials: RP
authors.lastname: Martin
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001011:Aorta / Q000293:injuries; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology*; D001017:Aortic Coarctation / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002648:Child; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult