Document Detail


Aortic coarctation complicated by wall aneurysm: The role of covered stents.
MedLine Citation:
PMID:  20824756     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Aortic aneurysm formation complicating aortic coarctation carries a risk of rupture with high mortality rate. Surgical repair has a significant mortality and may be associated with central nervous system injury, including paraplegia. Transcatheter intervention alternatively carries a risk of aneurysmal rupture.
METHODS: Between July 2004 and September 2009, 140 consecutive patients underwent percutaneous stent implantation to treat aortic coarctation. Eleven (7.9%) patients had coarctation associated with aortic wall aneurysm: three with native coarctation with wall aneurysm, three with previous surgical coarctation repair, three with previous balloon angioplasty, and two with previous bare stent implantation. The e-PTFE-covered 8Zig Cheatham-Platinum stents were used to treat all 11 patients.
RESULTS: Median age at procedure was 13 years (range, 6-66 years). Successful device deployment was achieved in all patients. Systolic pressure gradient reduced significantly from a median baseline of 30 mm Hg (range, 25-50 mm Hg) to a postprocedural median of 5 mm Hg (range, 0-20 mm Hg) (P < 0.01). Aortic diameter increased from a median value of 6 mm (range, 0.5-11 mm) to a median value of 12 mm (range, 10-22 mm) (P < 0.001). No early complications occurred, with successful relief of stenoses and complete sealing of all aneurysms. Median follow-up was 50 months (range, 16-61 months). Redilatation was required in four patients (one patient with intrastent restenosis secondary to significant endothelial growth, whereas the other three patients showed restenosis secondary to somatic growth). Redilatation with a larger balloon was performed without complication in all cases.
CONCLUSIONS: Our data show that covered stents are a safe and effective treatment with low risk of complications for the treatment of coarctation associated with aortic wall aneurysm. © 2011 Wiley Periodicals, Inc.
Authors:
Gianfranco Butera; Mohamed Heles; Simon T Macdonald; Mario Carminati
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Publication Detail:
Type:  Journal Article     Date:  2011-06-06
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  78     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  926-32     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley Periodicals, Inc.
Affiliation:
Pediatric Cardiology and GUCH Unit, Istituto Policlinico San Donato, IRCCS, San Donato Milanese, Italy. gianfra.but@lycos.com.
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