Xiong Jiang, Guo Wei, Liu Xiao-ping, Jia Xin, Ma Xiao-hui, Wang Li-jun, Zhang Hong-peng
Department of Vascular Surgery, People's Liberation Army General Hospital, Beijing 100853, China.
Zhonghua Wai Ke Za Zhi. 2012 Jul;50(7):629-32.
To evaluate the early and midterm results of covered Cheatham-Platinum (CP) stent for treatment of aortic coarctation (CoA) in adolescents and adults.
From January 2007 to June 2011, 9 consecutive cases of CoA underwent covered CP stent implantation. There were 4 male and 5 female patients, aging from 13 to 44 years with a mean of (24 ± 11) years. The covered CP stent and balloon-in-balloon catheter were selected according to digital subtraction angiography measurements. The covered CP stents were expanded to appropriate diameter by inflation of the inner balloon and outer balloon successively. The systolic pressure gradient across the stenosis and narrowest degree of the stenotic vessels were compared before and after the procedure.
After the procedure, the systolic pressure gradient across the stenosis decreased from (66 ± 21) mmHg to (9 ± 4) mmHg (1 mmHg = 0.133 kPa, t = 9.13, P = 0.000) and the narrowest degree of CoA decreased from 79% ± 12% to 17 ± 4% (t = 16.65, P = 0.000). During a mean follow-up of (33 ± 22) months (ranging 4 to 54 months), no intrastent restenosis were found and systolic pressure gradient from upper to low extremity was not more than 15 mmHg in each case.
Covered CP stent implantation is safe and effective for treatment of CoA in adolescents and adults. The early and midterm results are encouraging, but long term results require further follow-up and observation.
评估带膜Cheatham-Platinum(CP)支架治疗青少年及成人主动脉缩窄(CoA)的早期和中期效果。
2007年1月至2011年6月,连续9例CoA患者接受带膜CP支架植入术。其中男性4例,女性5例,年龄13至44岁,平均(24±11)岁。根据数字减影血管造影测量结果选择带膜CP支架及球囊导管。通过依次充盈内球囊和外球囊将带膜CP支架扩张至合适直径。比较手术前后狭窄部位的收缩压梯度及狭窄血管的最窄程度。
术后,狭窄部位的收缩压梯度从(66±21)mmHg降至(9±4)mmHg(1mmHg = 0.133kPa,t = 9.13,P = 0.000),CoA的最窄程度从79%±12%降至17±4%(t = 16.65,P = 0.000)。平均随访(33±22)个月(4至54个月),未发现支架内再狭窄,且每例患者上下肢收缩压梯度均不超过15mmHg。
带膜CP支架植入术治疗青少年及成人CoA安全有效。早期和中期结果令人鼓舞,但长期结果需要进一步随访观察。