Use of endovascular stents for the treatment of coarctation of the aorta in children and adults: immediate and midterm results.

OBJECTIVES

The aim of this study was to evaluate the use of endovascular stents in both native and recurrent coarctation of the aorta (CoA) in children and adults.

BACKGROUND

The use of stents in CoA as an alternative to surgery or balloon angioplasty has been shown to have favorable immediate and midterm results.

METHODS

Between May 1995 and February 2005, 44 patients (28 native and 16 with recoarctation after previous intervention) at a mean age of 16.9 +/- 1.8 years (range 3 months to 44 years) underwent stent implantation. Successful outcome was defined as a reduction in the peak systolic pressure gradient by 50% or more.

RESULTS

Stents were implanted in all 44 patients and successful outcomes occurred in all 44 patients. The peak systolic gradient decreased from a mean value of 29.2 +/- 1.9 mmHg (range from 7 to 55 mmHg) to a mean of 3.7 +/- 0.7 mmHg (range from 0 to 18 mmHg). Coarctation site diameter increased from a mean of 6.1 +/- 0.5 mm to a mean of 13 +/- 0.5 mm. Twelve patients underwent stent redilatation/repeat stent placement procedures between 7 to 47.5 months after the initial procedure. One patient underwent a repeat procedure after 1 day secondary to stent migration from the first procedure. Complications occurred in 9 patients, of which no patients required surgery. At a mean follow-up of 19.8 +/- 3.5 months (range 0.1 to 117 months), 1 patient developed an aneurysm at the site of stent implantation. This patient is awaiting surgical repair of the aneurysm. No other complications were noted. Therefore, we conclude that stent implantation for coarctation of the aorta is safe and effective with sustained good midterm results.