Butera Gianfranco, Gaio Gianpiero, Carminati Mario
Department of Pediatric Cardiology, GUCH unit and Cardiac Surgery-Policlinico San Donato IRCCS, San Donato Milanese, Italy.
Catheter Cardiovasc Interv. 2008 Aug 1;72(2):273-7. doi: 10.1002/ccd.21609.
To evaluate the possibility to redilate covered Cheatham-Platinum stents during follow-up, in particular in growing children with aortic coarctation.
There are no data in the literature about the redilation of ePTFE covered CP stents.
Sixty covered CP stents were implanted in patients with aortic coarctation or recoarctation between January 2004 and October 2007. Seven patients (mean age 14.2 +/- 3.7 years) needed to repeat the hemodynamic study due to somatic growth and increase of aortic gradient with the occurrence of systemic hypertension. Two had near-atretic aortic coarctation, three had postsurgical recoarctation and aneurysm formation, one had native aortic coarctation associated with aneurysm of the arterial wall, and one had severe native aortic coarctation.
Procedures were performed a mean of 20 +/- 5 months (range, 12-24 months) after the primary stent implantation. Fluoroscopy time ranged between 7 and 15 min (median, 10 min) whereas procedure time ranged between 60 and 75 min (median, 65 min). After redilation the gradient across the stenosis decreased from a median value of 35 mm Hg to a median value of 5 mm Hg. The stent diameter increased of 20-50% the predilation value. No complications occurred and angiographic controls showed that the stenoses have been relieved.
FOLLOW-UP: During a median follow-up of 12 months (6-30 months) the results were stable without complications.
Covered Cheatham-Platinum stents can be easily redilated.
评估在随访期间对带膜Cheatham - Platinum支架进行再扩张的可能性，尤其是在患有主动脉缩窄的生长发育中的儿童中。
文献中尚无关于ePTFE带膜CP支架再扩张的数据。
2004年1月至2007年10月期间，对60例患有主动脉缩窄或再缩窄的患者植入了带膜CP支架。7例患者（平均年龄14.2±3.7岁）因身体生长以及随着系统性高血压的出现主动脉梯度增加，需要重复进行血流动力学研究。其中2例为近闭锁性主动脉缩窄，3例为术后再缩窄并形成动脉瘤，1例为原发性主动脉缩窄合并动脉壁动脉瘤，1例为严重原发性主动脉缩窄。
在初次支架植入后平均20±5个月（范围12 - 24个月）进行了相关操作。透视时间在7至15分钟之间（中位数为10分钟），而操作时间在60至75分钟之间（中位数为65分钟）。再扩张后，狭窄部位两端的压力梯度从中位数35 mmHg降至中位数5 mmHg。支架直径增加到预扩张值的20% - 50%。未发生并发症，血管造影检查显示狭窄已解除。
在中位随访期12个月（6 - 30个月）内，结果稳定，无并发症发生。
带膜Cheatham - Platinum支架可轻松进行再扩张。
