title: Stent Repair for Complex Coarctation of Aorta.
abstract: OBJECTIVE
  This study sought to determine whether several anatomic or evolving characteristics of the coarctation may create challenging conditions for treatment.
  
  
  BACKGROUND
  Stent repair of coarctation of aorta is an alternative to surgical correction.
  
  
  METHODS
  We analyzed our 21-year experience in the percutaneous treatment of complex coarctation of aorta. Adverse conditions for treatment were as follow: 1) complete interruption of the aortic arch (n = 11); 2) associated aneurysm (n = 18); 3) complex stenosis (n = 30); and 4) the need for re-expansion and/or restenting (n = 21). Twenty patients (33%) belonged to more than 1 group. Ten interruptions were type A and 1 was type B. The mean length of the interrupted aorta was 9 ± 11 mm. The associated aneurysms were native in 8 patients and after previous intervention in 10 patients. Aneurysm shapes were fusiform in 8 patients and saccular in 10. The following characteristics defined complex stenosis as long diffuse stenosis, very tortuous coarctation, or stenosis involving a main branch or an unusual location. Patients previously stented at an early age, required re-expansion and/or restenting after reaching 16 ± 5 years of age.
  
  
  RESULTS
  Two patients had died by 1-month follow-up. The remaining 58 patients did well and were followed-up for a mean period of 10 ± 6 years. Late adverse events occurred in 3 patients (5%). All remaining patients are symptom-free, with normal baseline blood pressure. Imaging techniques revealed good patency at follow-up without associated aneurysm or restenosis. The actuarial survival free probability of all complex patients at 15 years was 92%.
  
  
  CONCLUSIONS
  Stent repair of complex coarctation of aorta is feasible and safe. Initial results are maintained at later follow-up.
authors: Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain. Electronic address: jsuarezdelezo@infonegocio.com.
authors: José
authors: J
authors: Suárez de Lezo
authors: Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain.
authors: Miguel
authors: M
authors: Romero
authors: Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain.
authors: Manuel
authors: M
authors: Pan
authors: Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain.
authors: Javier
authors: J
authors: Suárez de Lezo
authors: Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain.
authors: José
authors: J
authors: Segura
authors: Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain.
authors: Soledad
authors: S
authors: Ojeda
authors: Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain.
authors: Djordje
authors: D
authors: Pavlovic
authors: Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain.
authors: Francisco
authors: F
authors: Mazuelos
authors: Department of Cardiology, Reina Sofia University Hospital, University of Córdoba and Instituto Maimónides para la Investigación Biomédica en Córdoba, Córdoba, Spain.
authors: José
authors: J
authors: López Aguilera
authors: Department of Radiology, Reina Sofia University Hospital, University of Córdoba and IMIBIC, Córdoba, Spain.
authors: Simona
authors: S
authors: Espejo Perez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D001017:Aortic Coarctation / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D013030:Spain; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency; D055815:Young Adult
keywords: aortic aneurysm; complex coarctation of aorta; interrupted aortic arch; stent re-expansion; stent repair