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使用BeGraft主动脉支架治疗主动脉缩窄的可行性及早期结果。

Feasibility and early outcomes of aortic coarctation treatments with BeGraft Aortic stent.

作者信息

Promphan Worakan, Han Siang Koay, Prachasilchai Pimpak, Jarutach Jirayut, Makonkawkeyoon Krit, Siwaprapakorn Warawut, Chutimapongrat Nantapol, Sueachim Pantipa, Butchan Yuttana

机构信息

Pediatric Heart Center, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand.

Department of Pediatric Cardiology, Penang General Hospital, Penang, Malaysia.

出版信息

Catheter Cardiovasc Interv. 2020 Sep 1;96(3):E310-E316. doi: 10.1002/ccd.28892. Epub 2020 Apr 16.

Abstract

OBJECTIVES

To assess feasibility and early outcomes of using BeGraft Aortic stent in the treatment of aortic coarctation (CoA).

BACKGROUND

BeGraft Aortic stent (Bentley InnoMed, Hechingen, Germany) allows large postdilation diameter up to 30 mm. With availability of lengths of 19-59 mm and lower stent profile, they can be used in native and recurrent CoA in adults and in pediatric patients.

MATERIALS AND METHODS

This is a multicentre retrospective analysis of 12 implanted BeGraft Aortic stents in CoA between May 2017 and April 2019.

RESULTS

Twelve patients aged 7.7-38 years (median 18.3 years) with body weight of 19.9-56 kg (median 45.5 kg). Eight patients (66%) had native juxtaductal CoA while four had recurrent CoA after previous surgical or transcatheter treatments. The stents were implanted successfully in all the patients with no serious adverse events. The length of the stents ranged from 27 to 59 mm and the implanted stent diameter varied from 12 to 18 mm. The median intraprocedural CoA pressure gradient decreased from 25 mmHg (range 16-66 mmHg) to 2 mmHg (range 0-13 mmHg). The mean follow-up duration was 10.2 months. Two patient (16.6%) had residual stent narrowing requiring staged redilation. One patient (8%) had pseudoaneurysm formation at 1 year cardiac CT follow-up.

CONCLUSIONS

The BeGraft Aortic stent may be considered to be safe and effective in the short term in treatment of CoA from childhood to adulthood. Long-term follow-up is needed.

摘要

目的

评估使用BeGraft主动脉支架治疗主动脉缩窄(CoA)的可行性和早期疗效。

背景

BeGraft主动脉支架(德国黑兴根的本特利创新医疗公司)允许高达30毫米的大球囊扩张后直径。其长度为19 - 59毫米,支架轮廓较低,可用于成人和儿童患者的原发性和复发性CoA。

材料与方法

这是一项对2017年5月至2019年4月期间12例植入BeGraft主动脉支架治疗CoA患者的多中心回顾性分析。

结果

12例患者年龄7.7 - 38岁(中位年龄18.3岁),体重19.9 - 56千克(中位体重45.5千克)。8例患者(66%)为原发性导管周围CoA,4例患者为先前手术或经导管治疗后的复发性CoA。所有患者均成功植入支架,无严重不良事件。支架长度为27 - 59毫米,植入的支架直径为12 - 18毫米。术中CoA压力梯度中位数从25毫米汞柱(范围16 - 66毫米汞柱)降至2毫米汞柱(范围0 - 13毫米汞柱)。平均随访时间为10.2个月。2例患者(16.6%)存在残余支架狭窄,需要分期进行再扩张。1例患者(8%)在心脏CT随访1年时出现假性动脉瘤形成。

结论

BeGraft主动脉支架在治疗儿童至成人CoA的短期应用中可能被认为是安全有效的。需要进行长期随访。

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