Dikmen Nur, Ozcinar Evren, Eyileten Zeynep, Hasde Ali Ihsan, Yazicioglu Levent, Kaya Bulent, Uysalel Adnan
Faculty of Medicine, Ankara University, 06100 Ankara, Türkiye.
J Clin Med. 2024 Sep 28;13(19):5814. doi: 10.3390/jcm13195814.
Aortic coarctation, a condition characterized by localized narrowing of the aorta, can be managed with either surgical or endovascular techniques. This study aims to compare these approaches concerning long-term outcomes, particularly re-coarctation rates and late arterial hypertension. We retrospectively analyzed data from patients with native, isolated aortic coarctation treated by surgical or endovascular methods between 2015 and 2024. Clinical and demographic data were collected from electronic health records. Blood pressure was measured using oscillometric devices, and transthoracic echocardiography (TTE) was performed by an experienced sonographer. The primary endpoint was to identify which treatment predicted re-coarctation during follow-up, while the secondary endpoint assessed the incidence of late arterial hypertension. Sixty-nine patients were included, with a mean age of 18.14 ± 8.18 years (median 16 years; range 8 to 37 years) and a median follow-up of 3 years (range 6 months to 8 years). Of these, 67 (97.1%) underwent elective repairs. Repair techniques included endovascular treatment (24.6%), surgical end-to-end anastomosis (47.8%), and surgical patchplasty (27.5%). The endovascular group was significantly older (29.82 ± 5.9 years vs. 14.33 ± 4.25 years, = 0.056) and had shorter procedure durations and hospital stays. One-year freedom from reintervention was significantly higher in the surgical group (98.7%) compared to the endovascular group (88.23%) ( < 0.001). Both techniques effectively treat aortic coarctation, but surgical repair offers better long-term outcomes, while endovascular repair provides shorter recovery times. These findings should inform the choice of treatment modality based on patient-specific factors and clinical priorities.
主动脉缩窄是一种以主动脉局部狭窄为特征的疾病，可通过手术或血管内技术进行治疗。本研究旨在比较这些方法在长期预后方面的差异，特别是再缩窄率和晚期动脉高血压。我们回顾性分析了2015年至2024年间接受手术或血管内方法治疗的原发性、孤立性主动脉缩窄患者的数据。临床和人口统计学数据从电子健康记录中收集。使用示波装置测量血压，并由经验丰富的超声心动图医师进行经胸超声心动图（TTE）检查。主要终点是确定哪种治疗方法可预测随访期间的再缩窄，次要终点评估晚期动脉高血压的发生率。纳入69例患者，平均年龄18.14±8.18岁（中位数16岁；范围8至37岁），中位随访时间3年（范围6个月至8年）。其中，67例（97.1%）接受了择期修复。修复技术包括血管内治疗（24.6%）、手术端端吻合（47.8%）和手术补片成形术（27.5%）。血管内治疗组患者年龄显著较大（29.82±5.9岁 vs. 14.33±4.25岁， = 0.056），手术时间和住院时间较短。手术组1年无需再次干预的比例（98.7%）显著高于血管内治疗组（88.23%）（ < 0.001）。两种技术均能有效治疗主动脉缩窄，但手术修复的长期预后更好，而血管内修复的恢复时间更短。这些发现应根据患者的具体因素和临床优先级为治疗方式的选择提供参考。
