title: Use of a hand-made balloon-expandable covered stent for native coarctation of the aorta in an adult patient: a report of a first case in Japan.
abstract: In western countries, the use of a balloon-expandable covered stent is recommended for the treatment of native coarctation of the aorta (CoA) in adult patients because endovascular bare stents cannot completely prevent complications such as aneurysms or aortic rupture. However, such a product that is appropriate and officially approved is not available in Japan. We developed and used a handmade balloon-expandable covered stent in a 32-year-old patient with native CoA and achieved a good outcome. A Palmaz-Schatz stent (XL 10-series 4010; Johnson & Johnson, Warren, NJ, USA) was covered with an Ube woven-graft (WST series; 18 mm across; Ube Junken Medical, Tokyo, Japan). Because the stent shortens when dilated, one end of the graft was firmly sutured to one end of the stent, whereas the other end of the graft was stitched loosely to the other end of the stent so that it could slide along the struts of the stent to accommodate foreshortening. After meticulous in vitro simulations, the covered stent was implanted with right ventricular overdrive pacing. No complications were observed, and the pressure gradient disappeared. These results indicate that angioplasty using a balloon-expandable covered stent is highly safe and effective for correcting native CoA in adult patients and hopefully in children.
authors: Department of Pediatric Cardiology, Stroke & Cardiovascular Center, Ehime University Hospital, Ehime, Japan. higaki@m.ehime-u.ac.jp
authors: Takashi
authors: T
authors: Higaki
authors: Eiichi
authors: E
authors: Yamamoto
authors: Masahiro
authors: M
authors: Ryugo
authors: Hiroshi
authors: H
authors: Imagawa
authors: Fumiaki
authors: F
authors: Shikata
authors: Mitsugi
authors: M
authors: Nagashima
authors: Masaaki
authors: M
authors: Ohta
authors: Hidemi
authors: H
authors: Takata
authors: Kikuko
authors: K
authors: Murao
authors: Toshiyuki
authors: T
authors: Chisaka
authors: Tomozo
authors: T
authors: Moritani
authors: Ryusuke
authors: R
authors: Watanabe
authors: Hideshi
authors: H
authors: Tomita
authors: Kanji
authors: K
authors: Kawachi
authors: Eiichi
authors: E
authors: Ishii
mesh_terms: D000328:Adult; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods*; D001017:Aortic Coarctation / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D020099:Coated Materials, Biocompatible; D005260:Female; D006801:Humans; D007564:Japan; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible