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覆膜支架与非覆膜支架治疗主动脉缩窄的早期和晚期结果-单中心经验。

Early and late outcome of covered and non-covered stents in the treatment of coarctation of aorta- A single centre experience.

机构信息

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.

出版信息

Indian Heart J. 2020 Jul-Aug;72(4):278-282. doi: 10.1016/j.ihj.2020.06.012. Epub 2020 Jul 2.

Abstract

OBJECTIVE

Stenting of coarctation of aorta with covered or uncovered stents is the accepted modality of treatment in older children and adults. The indications which mandate the use of covered stents are still unclear. We attempted to study the early and late outcomes after stenting of native and recurrent coarctation of aorta with uncovered and covered stents.

METHOD

This is a retrospective study of patients who underwent stenting for coarctation of aorta with covered or non-covered stents at our institute. Early and late outcome for both the groups were studied.

RESULTS

Twenty patients underwent implantation of covered stent and twenty five patients had uncovered stent implantation. Patients in the covered stent group were older and had greater basal pressure gradient. More patients in the covered stent group had residual gradient >10 mm Hg after the procedure. There was no mortality or aortic wall injury in either group. Four patients in the covered stent group underwent planned re-intervention and two had unplanned re-intervention. None of the patients in the uncovered stent group had re-intervention. Higher incidence of late lumen loss was noted in the covered stent group.

CONCLUSION

Uncovered stents can be safely implanted with minimal risk of aortic wall injury in patients with low risk anatomic features. Covered stent implantation is associated with higher incidence of planned and unplanned re-intervention.

摘要

目的

带或不带覆膜的支架治疗主动脉缩窄在大龄儿童和成人中是一种公认的治疗方法。但仍不清楚需要使用覆膜支架的指征。我们试图研究使用裸支架和覆膜支架治疗原发性和复发性主动脉缩窄的早期和晚期结果。

方法

这是一项在我们机构对接受带或不带覆膜支架治疗主动脉缩窄的患者进行的回顾性研究。研究了两组的早期和晚期结果。

结果

20 名患者植入了覆膜支架,25 名患者植入了裸支架。覆膜支架组患者年龄较大,基础压力梯度较大。更多的覆膜支架组患者在手术后仍有>10mmHg 的残余梯度。两组均无死亡或主动脉壁损伤。覆膜支架组中有 4 名患者进行了计划再介入,2 名患者进行了非计划再介入。裸支架组无一例患者需要再介入。覆膜支架组的晚期管腔丢失发生率较高。

结论

对于解剖学特征低危的患者,植入裸支架具有最小的主动脉壁损伤风险,是安全的。覆膜支架植入与计划和非计划再次介入的发生率较高有关。

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