Document Detail


Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta.
MedLine Citation:
PMID:  17896405     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques. METHODS AND RESULTS: Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005. About 27% (160/588) procedures were followed up by further IAI of their aorta (MRI/CT/repeat cardiac catheterization) after initial stent procedures. Abnormal imaging studies included: the presence of dissection or aneurysm formation, stent fracture, or the presence of reobstruction within the stent (instent restenosis or significant intimal build-up within the stent). Forty-one abnormal imaging studies were reported in the intermediate follow-up at median 12 months (0.5-92 months). Smaller postintervention of the aorta (CoA) diameter and an increased persistent systolic pressure gradient were associated with encountering abnormal follow-up imaging studies. Aortic wall abnormalities included dissections (n = 5) and aneurysm (n = 13). The risk of encountering aortic wall abnormalities increased with larger percent increase in CoA diameter poststent implant, increasing balloon/coarc ratio, and performing prestent angioplasty. Stent restenosis was observed in 5/6 parts encountering stent fracture and neointimal buildup (n = 16). Small CoA diameter poststent implant and increased poststent residual pressure gradient increased the likelihood of encountering instent restenosis at intermediate follow-up. CONCLUSIONS: Abnormalities were observed at intermediate follow-up following IS placement for treatment of native and recurrent coarctation of the aorta. Not exceeding a balloon:coarctation ratio of 3.5 and avoidance of prestent angioplasty decreased the likelihood of encountering an abnormal follow-up imaging study in patients undergoing intravascular stent placement for the treatment of coarctation of the aorta. We recommend IAI for all patients undergoing IS placement for treatment of CoA.
Authors:
Thomas J Forbes; Phillip Moore; Carlos A C Pedra; Evan M Zahn; David Nykanen; Zahid Amin; Swati Garekar; David Teitel; Shakeel A Qureshi; John P Cheatham; Makram R Ebeid; Ziyad M Hijazi; Satinder Sandhu; Donald J Hagler; Horst Sievert; Thomas E Fagan; Jeremy Ringwald; Wei Du; Liwen Tang; David F Wax; John Rhodes; Troy A Johnston; Thomas K Jones; Daniel R Turner; Robert Pass; Alejandro Torres; William E Hellenbrand
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  70     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-02     Completed Date:  2008-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  569-77     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley-Liss, Inc.
Affiliation:
Children's Hospital of Michigan, Wayne State University, Detroit, Michigan, USA. tforbes@dmc.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aneurysm, Dissecting / etiology,  pathology,  radiography
Angioplasty, Balloon / adverse effects,  instrumentation*
Aorta, Thoracic* / pathology,  radiography
Aortic Aneurysm / etiology,  pathology,  radiography
Aortic Coarctation / pathology,  radiography,  therapy*
Aortography / methods*
Brazil
Child
Constriction, Pathologic / etiology,  pathology,  radiography
Europe
Follow-Up Studies
Heart Catheterization*
Humans
Magnetic Resonance Angiography*
Practice Guidelines as Topic
Prosthesis Failure
Research Design
Retrospective Studies
Stents*
Time Factors
Tomography, X-Ray Computed*
Treatment Outcome
United States

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


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