Use of covered stents in the management of coarctation of the aorta

We report our experience with the use of covered stents for the management of coarctation of the aorta. From December 2001 to March 2004, nine patients (seven males; median age, 31 years; mean weight, 65 +/- 15 kg) underwent implantation. Indications included critical or atretic native coarctation (...

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Veröffentlicht in:Pediatric cardiology 2005-08, Vol.26 (4), p.431-439
Hauptverfasser: Pedra, C A C, Fontes, V F, Esteves, C A, Arrieta, S R, Braga, S L N, Justino, H, Kambara, A M, Moreira, S M, Sousa, J E R
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container_end_page 439
container_issue 4
container_start_page 431
container_title Pediatric cardiology
container_volume 26
creator Pedra, C A C
Fontes, V F
Esteves, C A
Arrieta, S R
Braga, S L N
Justino, H
Kambara, A M
Moreira, S M
Sousa, J E R
description We report our experience with the use of covered stents for the management of coarctation of the aorta. From December 2001 to March 2004, nine patients (seven males; median age, 31 years; mean weight, 65 +/- 15 kg) underwent implantation. Indications included critical or atretic native coarctation (n = 4), patients >50 years of age (n = 2), associated patent ductus arteriosus (n = 1) or adjacent aneurysm (n = 1), and the presence of a circumferential fracture within a previously implanted stent (n = 1). The covered balloon-expandable Cheatham-Platinum stent and the self-expandable stent graft Braile were employed. Adequate implantation was observed in all patients. Gradients were reduced from 54 +/- 14 to 3 +/- 8 mmHg and the coarctation site increased from 2.4 +/- 2.9 to 15.9 +/- 4.3 mm. The patent ductus arteriosus was immediately closed and the aneurysm excluded. Two patients >35 years with aneurysmal ascending aorta and metallic aortic prosthesis had aneurysm formation at follow-up, with one undergoing aneurysm exclusion using a Braile stent. Although covered stents are useful in the management of selected patients with coarctation, aneurysm formation may still occur in patients with markers of aortic wall weakness. Refinements in the deployment technique and/or the stent design are needed to eliminate this risk.
doi_str_mv 10.1007/s00246-004-0814-2
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From December 2001 to March 2004, nine patients (seven males; median age, 31 years; mean weight, 65 +/- 15 kg) underwent implantation. Indications included critical or atretic native coarctation (n = 4), patients &gt;50 years of age (n = 2), associated patent ductus arteriosus (n = 1) or adjacent aneurysm (n = 1), and the presence of a circumferential fracture within a previously implanted stent (n = 1). The covered balloon-expandable Cheatham-Platinum stent and the self-expandable stent graft Braile were employed. Adequate implantation was observed in all patients. Gradients were reduced from 54 +/- 14 to 3 +/- 8 mmHg and the coarctation site increased from 2.4 +/- 2.9 to 15.9 +/- 4.3 mm. The patent ductus arteriosus was immediately closed and the aneurysm excluded. Two patients &gt;35 years with aneurysmal ascending aorta and metallic aortic prosthesis had aneurysm formation at follow-up, with one undergoing aneurysm exclusion using a Braile stent. Although covered stents are useful in the management of selected patients with coarctation, aneurysm formation may still occur in patients with markers of aortic wall weakness. 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Refinements in the deployment technique and/or the stent design are needed to eliminate this risk.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aortic coarctation</subject><subject>Aortic Coarctation - diagnostic imaging</subject><subject>Aortic Coarctation - surgery</subject><subject>Aortography</subject><subject>Blood Vessel Prosthesis Implantation - instrumentation</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Coated Materials, Biocompatible</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Polytetrafluoroethylene</subject><subject>Retrospective Studies</subject><subject>Stent (Surgery)</subject><subject>Stents</subject><subject>Treatment Outcome</subject><issn>0172-0643</issn><issn>1432-1971</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkU1LxDAQhoMoun78AC9SELxFZ9I0bY-y-AWCFz2HbDpdK22jSVbw35vSBRGWOYR5ed6B8DB2jnCNAOVNABBScQDJoULJxR5boMwFx7rEfbYALAUHJfMjdhzCBwBUUBWH7AiLQtYKywVbvgXKXJtZ902emixEGmPIujGL75QNZjRrGlI0M8bbaGLnxmmdAON8NKfsoDV9oLPte8Le7u9el4_8-eXhaXn7zK0sIfJylRtbN0pUK4sWCJVoESoJpGhFJA0aqooUCYu1ygsspbV1RUolpqkhP2FX891P7742FKIeumCp781IbhO0qmoBRTmBlzO4Nj3pbmxd9MZOsL7FQkC6CHWi-A5qTSN507uR2i7F__jrHXyahobO7izgXLDeheCp1Z--G4z_0Qh6EqhngToJ1JNALVLnYvvHzWqg5q-xNZb_AmXwkuM</recordid><startdate>200508</startdate><enddate>200508</enddate><creator>Pedra, C A C</creator><creator>Fontes, V F</creator><creator>Esteves, C A</creator><creator>Arrieta, S R</creator><creator>Braga, S L N</creator><creator>Justino, H</creator><creator>Kambara, A M</creator><creator>Moreira, S M</creator><creator>Sousa, J E R</creator><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200508</creationdate><title>Use of covered stents in the management of coarctation of the aorta</title><author>Pedra, C A C ; Fontes, V F ; Esteves, C A ; Arrieta, S R ; Braga, S L N ; Justino, H ; Kambara, A M ; Moreira, S M ; Sousa, J E R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-7b3ac9d628bc1c0e162f10840e6ebee4a1ae85f102c19635174cc98e66840d903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aortic coarctation</topic><topic>Aortic Coarctation - diagnostic imaging</topic><topic>Aortic Coarctation - surgery</topic><topic>Aortography</topic><topic>Blood Vessel Prosthesis Implantation - instrumentation</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Coated Materials, Biocompatible</topic><topic>Diagnosis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Polytetrafluoroethylene</topic><topic>Retrospective Studies</topic><topic>Stent (Surgery)</topic><topic>Stents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pedra, C A C</creatorcontrib><creatorcontrib>Fontes, V F</creatorcontrib><creatorcontrib>Esteves, C A</creatorcontrib><creatorcontrib>Arrieta, S R</creatorcontrib><creatorcontrib>Braga, S L N</creatorcontrib><creatorcontrib>Justino, H</creatorcontrib><creatorcontrib>Kambara, A M</creatorcontrib><creatorcontrib>Moreira, S M</creatorcontrib><creatorcontrib>Sousa, J E R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pedra, C A C</au><au>Fontes, V F</au><au>Esteves, C A</au><au>Arrieta, S R</au><au>Braga, S L N</au><au>Justino, H</au><au>Kambara, A M</au><au>Moreira, S M</au><au>Sousa, J E R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of covered stents in the management of coarctation of the aorta</atitle><jtitle>Pediatric cardiology</jtitle><addtitle>Pediatr Cardiol</addtitle><date>2005-08</date><risdate>2005</risdate><volume>26</volume><issue>4</issue><spage>431</spage><epage>439</epage><pages>431-439</pages><issn>0172-0643</issn><eissn>1432-1971</eissn><abstract>We report our experience with the use of covered stents for the management of coarctation of the aorta. 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source MEDLINE; Springer Online Journals
subjects Adolescent
Adult
Aged
Aortic coarctation
Aortic Coarctation - diagnostic imaging
Aortic Coarctation - surgery
Aortography
Blood Vessel Prosthesis Implantation - instrumentation
Care and treatment
Child
Coated Materials, Biocompatible
Diagnosis
Female
Follow-Up Studies
Humans
Male
Middle Aged
Polytetrafluoroethylene
Retrospective Studies
Stent (Surgery)
Stents
Treatment Outcome
title Use of covered stents in the management of coarctation of the aorta
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