Implantation of balloon-expandable stents for coarctation of the aorta: Implantation data and short-term results

We report the immediate results and the short‐term follow‐up in a group of selected patients with coarctation of the aorta who underwent endovascular stent implantation. Balloon‐expandable stents were implanted in 6 patients (mean age 19.8 ± 5.1 years) with coarctation of the aorta (4 recurrent and 2 native) who underwent a total of 7 procedures (6 implantation and 1 further expansion). The systolic peak pressure gradient was decreased from 36.7 ± 16.9 to 13.3 ± 23.2 mm Hg (P < 0.005). There was a 66% increase in the mean coarctation diameter from 9.3 ± 1.7 to 15.6 ± 3.1 mm (P = 0.001) with the ratio of the coarctation to descending aorta diameter, measured at the level of the diaphragm, increasing from 0.49 ± 0.1 to 0.81 ± 0.2 (P < 0.005). The dilatation was successful in expanding the stent to an acceptable diameter in 5 of 6 patients. One patient underwent successful further expansion of a stent implanted 22 months previously. There were no immediate complications during balloon expansion and stent implantation. One patient suffered a femoral arterial bleed requiring surgical repair. There was one unrelated death. All patients were hypertensive (systolic blood pressure >140 mm Hg) prior to stent implantation. At mean follow‐up of 8 months, 3 patients are normotensive. There was no recurrence of coarctation, aortic dissection, or aneurysm formation in the patients in whom stent implantation was successful. These findings indicate that balloon‐expandable stent implantation for coarctation of the aorta in selected patients is a safe and effective alternative approach for relieving the obstruction with a low complication rate and no recoarctation at short‐term follow‐up. © 1996 Wiley‐Liss, Inc.