Document Detail


Endovascular management of adult coarctation and its complications: intermediate results in a cohort of 22 patients.
MedLine Citation:
PMID:  19635674     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the safety and effectiveness of current endovascular treatment in adult patients with thoracic aortic coarctation and its complications.
METHODS: A cohort of 22 patients was treated for late presenting primary or recurrent coarctation or aneurysmal formation at varying intervals following childhood intervention.
RESULTS: Ten patients with recently discovered de novo coarctations were treated with balloon-expandable stents, and an endoluminal graft (ELG) was used in one additional patient. In the other 11 patients with recurrent lesions, three underwent repeat balloon dilation and stenting; eight patients with recurrence with aneurysms received ELGs. The gradients across the coarctation decreased from 49 + 16 to 4 + 7 mmHg (p = 0.001), and the diameters increased from 10 + 4 to 19 + 4mm (p = 0.001). In five of the eight patients (63%) with aneurysms, the ELG covered the subclavian artery, and a carotid subclavian bypass was necessary. Two patients required iliac artery access. No early major complications occurred. At mean follow-up of 31 + 15.6 months, one patient with type II leak resolved spontaneously and another developed neck dilation and type I leak, requiring a second ELG placement. All patients except one had improvements in symptoms and better hypertension control.
CONCLUSIONS: We conclude that primary or secondary endovascular intervention in adults with de novo or recurrent coarctation and aneurysms is feasible with good intermediate results.
Authors:
Hani Shennib; Julio Rodriguez-Lopez; Venkatesh Ramaiah; Grayson Wheatley; Jacques Kpodonu; James Williams; Dawn Olson; Edward B Diethrich
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-07-26
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  37     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2011-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  322-7     Citation Subset:  IM    
Copyright Information:
Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Affiliation:
Arizona Heart Institute and Hospital, Phoenix, AZ, USA. hanishennib@email.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Angioplasty, Balloon / adverse effects,  methods
Aorta, Thoracic / abnormalities*
Aortic Aneurysm, Thoracic / surgery
Aortic Coarctation / radiography,  surgery,  therapy*
Blood Vessel Prosthesis Implantation / methods
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Recurrence
Stents
Tomography, X-Ray Computed
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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