Coarctation of the aorta treated with the Advanta V12 large diameter stent: acute results.
OBJECTIVE
To report on the early results of treatment of coarctation of the aorta by dilation with a new polytetrafluoroethylene covered stent.


BACKGROUND
Transcatheter dilation of aortic coarctation carries the risk of aneurysm or rupture. Covered stent implantation reduces this risk but requires a large delivery system. The Advanta V12 LD covered stent is premounted and requires a 9-11 Fr delivery system.


METHODS
Covered stents on balloons of a diameter sufficient to anchor the stent in the coarctation were implanted using the smallest available delivery system. Secondary dilation with larger diameter balloons was performed until the pressure gradient was <20 mm Hg and the stent was opposed to the aortic wall.


RESULTS
Twenty-five patients with aortic coarctation underwent stent implantation. Coarctation diameter increased from (6.3 + or - 3.5) mm to (14.4 + or - 2.3) mm (P < 0.0001). Peak pressure gradient decreased from (25.3 + or - 11.6) mm Hg to (2.5 + or - 3.0) mm Hg (P < 0.0001). The stent achieved the desired diameter in all cases. There were no complications. At short-term median follow-up of 4.9 months, all patients are alive and well with no evidence of recoarctation or aneurysm.


CONCLUSIONS
These initial results show that the covered Advanta V12LD stent is safe and effective in the immediate treatment of coarctation of the aorta through a low profile delivery system of 8-11 Fr. Long term follow up is required.
Bruckheimer
Elchanan
E
Pediatric Cardiac Catheterization, Schneider Children's Medical Center Israel, Kaplan 14, Petach Tikva, Israel. elchananb@bezeqint.net
Birk
Einat
E
Santiago
Raul
R
Dagan
Tamir
T
Esteves
Carlos
C
Pedra
Carlos A C
CA
D000293:Adolescent; D000328:Adult; D001017:Aortic Coarctation / Q000628:therapy*; D006328:Cardiac Catheterization; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D020099:Coated Materials, Biocompatible; D006801:Humans; D011138:Polytetrafluoroethylene; D019919:Prosthesis Implantation; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult
D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene