| Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta. | |
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MedLine Citation:
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PMID: 17896405 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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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:
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Created Date: 2007-10-02 Completed Date: 2008-01-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 569-77 Citation Subset: IM |
Copyright Information:
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(c) 2007 Wiley-Liss, Inc. |
Affiliation:
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Children's Hospital of Michigan, Wayne State University, Detroit, Michigan, USA. tforbes@dmc.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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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