Pol Arch Intern Med. 2017 Aug 9;127(7-8):498-505. doi: 10.20452/pamw.4042. Epub 2017 Jun 5.
INTRODUCTION Stent implantation has become the treatment of choice for native aortic coarctation (CoA) and postsurgical aortic recoarctation (reCoA) in adults and adolescents. OBJECTIVES This study aimed to compare the immediate and long‑term outcomes of patients with native CoA and postsurgical reCoA who underwent stent implantation in our center. PATIENTS AND METHODS The data of 136 patients with native CoA and reCoA who underwent stent implantation between May 1999 and December 2016 were retrospectively analyzed. The study population was divided into 2 groups: 108 patients with native CoA and 28 patients with reCoA. Clinical and procedural characteristics and immediate and long‑term outcomes after the intervention were compared between the groups. The use of antihypertensive drugs was analyzed in all patients. RESULTS There were no significant differences in the clinical characteristics of the study groups. The gradient before the intervention was significantly higher in the native CoA than in the reCoA group (P = 0.011), and the diameter of stenosis before the intervention was smaller in the native CoA group compared with the ReCoA group (P = 0.003). Procedural treatment was successful in 77.8% of the patients with native CoA and 78.5% of those with reCoA. There were no differences in the immediate and long‑term outcomes between the groups. The antihypertensive treatment was tapered or discontinued in about 34% of the study population. CONCLUSIONS Stenting is an effective and safe procedure in patients with native CoA and reCoA, with good late outcomes.
支架植入术已成为成人和青少年原发性主动脉缩窄(CoA)和术后主动脉再缩窄(reCoA)的首选治疗方法。
本研究旨在比较在我们中心接受支架植入术的原发性 CoA 和术后再 CoA 患者的即刻和长期结果。
回顾性分析了 1999 年 5 月至 2016 年 12 月期间接受支架植入术的 136 例原发性 CoA 和再 CoA 患者的数据。研究人群分为 2 组:108 例原发性 CoA 患者和 28 例再 CoA 患者。比较了两组患者的临床和手术特征以及干预后的即刻和长期结果。分析了所有患者的降压药物使用情况。
两组患者的临床特征无显著差异。介入前梯度在原发性 CoA 组明显高于再 CoA 组(P = 0.011),而原发性 CoA 组介入前狭窄程度明显小于再 CoA 组(P = 0.003)。77.8%的原发性 CoA 患者和 78.5%的再 CoA 患者的手术治疗均获得成功。两组患者的即刻和长期结果无差异。约 34%的研究人群的降压治疗逐渐减少或停止。
支架植入术在原发性 CoA 和再 CoA 患者中是一种有效且安全的方法,具有良好的晚期结果。