title: Acute outcome of stent therapy for coarctation of the aorta: results of the coarctation of the aorta stent trial.
abstract: OBJECTIVE
  The coarctation of the aorta stent trial (COAST) is a pivotal trial of the NuMED Cheatham Platinum Stent(®) for treatment of coarctation of the aorta (CoA).
  
  
  BACKGROUND
  CoA is a congenital obstruction to flow through the aorta. Stents have been used since the 1990s to treat CoA; none have been approved by the Food and Drug Administration for this indication.
  
  
  METHODS
  In a prospective, multicenter study 105 patients received stents for treatment of CoA. Data was collected in the catheterization laboratory, on discharge and at 1-month postprocedure.
  
  
  RESULTS
  Of 105 patients, 69% were male; 57% had native CoA. Noninvasive, baseline systolic blood pressure (SBP) showed upper extremity (UE) SBP to be 140 ± 16 mm Hg and UE to lower extremity (LE) SBP difference 29 ± 17 mm Hg. At catheterization, baseline ratio of minimum CoA diameter to diameter of descending aorta (CoA:DAo) was 0.46 ± 0.16. Implants (104/105) were successful with one stent migration. There were no deaths or serious complications. Paradoxical hypertension occurred in 6%. Four percent of patients experienced somewhat serious adverse events related to the procedure. All patients achieved relief of ascending aorta to Dao pressure gradient: mean = 2.0 ± 4.0 mm Hg (P < 0.001). The CoA:DAo increased to 0.84 ± 0.18. At 1-month, UE SBP was 120 ± 12 mm Hg, UE to LE SBP difference = -1 ± 12 mm Hg. Ninety-nine percent of patients had UE to LE SBP difference <20 mm Hg.
  
  
  CONCLUSIONS
  Stenting of CoA, using the NuMED Cheatham Platinum Stent, is acutely safe and effective for treatment of CoA.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Ringel
authors.forename: Julie
authors.initials: J
authors.lastname: Vincent
authors.forename: Kathy J
authors.initials: KJ
authors.lastname: Jenkins
authors.forename: Kimberlee
authors.initials: K
authors.lastname: Gauvreau
authors.forename: Heidi
authors.initials: H
authors.lastname: Moses
authors.forename: Kimberly
authors.initials: K
authors.lastname: Lofgren
authors.forename: Kudret
authors.initials: K
authors.lastname: Usmani
mesh_terms: D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D001017:Aortic Coarctation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure; D002406:Catheterization, Peripheral; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010984:Platinum; D011446:Prospective Studies; D011474:Prosthesis Design; D012008:Recurrence; D012039:Regional Blood Flow; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D010984:Platinum
keywords: cardiac catheterization; congenital heart disease; hypertension