Document Detail

First-in-man use of a tapered endovascular stent graft for treatment of aneurysm after coarctation repair.
MedLine Citation:
PMID:  20506193     Owner:  NLM     Status:  In-Process    
OBJECTIVES: Endovascular stenting of aneurysms late after surgical repair of coarctation may have to deal with marked changes in aortic diameter proximal and distal to the aneurysm. We report our first-in-man successful use of a custom-made tapered (variable diameter) covered stent.
METHODS: The aneurysm was 42 mm in diameter with a length of 40 mm. On MRI, the aorta measured 19.6 mm proximal and 13.3 mm distal to the aneurysm. The aim was to oversize the stent by 10-20%. A covered Cheatham-platinum stent was designed so that cranial portion of the stent would expand to 22 mm and the caudal portion to 15 mm with a length of 8.5 cm when fully inflated. The stent was mounted on a balloon-in-balloon delivery system and was delivered through an 18 F femoral arterial sheath. Rapid-pacing technique was used for deployment.
RESULTS: The stent was successfully deployed without complications. After deployment, the stent diameter measured 21.2 mm cranially and 15.6 mm caudally. A mild distal endoleak due to inadequate fixation of the stent graft was resolved by post dilation expanding the stent diameter to 22.1 mm and 15.9 mm, respectively. The femoral access site was closed using two percutaneous closure devices and the patient discharged the day after the procedure. Follow-up CT-angiography showed continued successful exclusion of the aneurysm.
CONCLUSIONS: A new custom-made balloon expandable covered stent-design enabled successful treatment of an aortic aneurysm. This design may offer greater potential for more favorable initial angiographic results and potentially long-term outcomes due to superior apposition to the aortic wall.
Fabian Nietlispach; Jonathon Leipsic; Namal Wijesinghe; John G Webb; Ronald G Carere
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  76     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1035-40     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Wiley-Liss, Inc.
Division of Cardiology, Department of Medicine, St Paul's Hospital, Vancouver, British Columbia, Canada.
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