Chessa Massimo, Carrozza Marianna, Butera Gianfranco, Piazza Luciane, Negura Diana Gabriela, Bussadori Claudio, Bossone Edoardo, Giamberti Alessandro, Carminati Mario
Pediatric Cardiology Department and Adult with Congenital Heart Disease, GUCH Unit, Policlinico San Donato, San Donato M.se, Milan, Italy.
Eur Heart J. 2005 Dec;26(24):2728-32. doi: 10.1093/eurheartj/ehi491. Epub 2005 Sep 26.
Since the late 1980s, endovascular stents have been used in the treatment of several vascular lesions. In the last decades, stent implantation has been proposed as a reliable option for the treatment of coarctation of the aorta. In this setting, it seems to have some advantages, rendering it superior to angioplasty alone.
Between December 1997 and December 2004, 71 consecutive patients (44 males and 27 females) underwent cardiac catheterization for native or recurrent coarctation of the aorta. Seventy-four stents were implanted. All discharged patients were enrolled in a follow-up programme. Every patient underwent clinical evaluation, echo-colour Doppler studies, and exercise ECG at 1 and 6 months after the stent implantation. Peak systolic gradient dropped from 39.3 +/- 15.3 to 3.6 +/- 5.5 mmHg (P = 0.0041). The diameter of the coarcted segment increased from 8.3 +/- 2.9 to 16.4 +/- 3.8 mm (P = 0.037). In our series, one death occurred in a 22-year-old girl with a recurrent coarctation of the aorta, just after stent implantation. The rate of minor complications was <2%. Re-dilatation of a previously implanted stent was performed in three patients.
In our experience (the largest reported to the best of our knowledge), stenting of a coarctation/re-coarctation of the aorta represents a safe alternative treatment without a significant mid-long-term complication.
自20世纪80年代末以来，血管内支架已被用于治疗多种血管病变。在过去几十年中，支架植入术已被提议作为治疗主动脉缩窄的可靠选择。在这种情况下，它似乎具有一些优势，使其优于单纯血管成形术。
在1997年12月至2004年12月期间，71例连续患者（44例男性和27例女性）因原发性或复发性主动脉缩窄接受了心导管检查。共植入了74个支架。所有出院患者均纳入随访计划。每位患者在支架植入后1个月和6个月接受临床评估、彩色多普勒超声检查和运动心电图检查。收缩期峰值压差从39.3±15.3 mmHg降至3.6±5.5 mmHg（P = 0.0041）。缩窄段直径从8.3±2.9 mm增加到16.4±3.8 mm（P = 0.037）。在我们的系列病例中，一名22岁患有复发性主动脉缩窄的女孩在支架植入后不久死亡。轻微并发症发生率<2%。3例患者对先前植入的支架进行了再次扩张。
根据我们的经验（据我们所知是已报道的最大系列病例），主动脉缩窄/再缩窄的支架置入术是一种安全的替代治疗方法，中长期并发症发生率低。
