Zhang Xiaoxue, Li Shiliang, Ma Xiantao, Akilu Wajeehullahi, Cheng Cai
Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Qiaokou District, Wuhan 430030, Hubei Province, China.
Division of Cardiothoracic and Vascular Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang, China.
Eur Heart J Case Rep. 2025 Mar 18;9(3):ytaf094. doi: 10.1093/ehjcr/ytaf094. eCollection 2025 Mar.
Coarctation of the aorta is often associated with aortic dilatation, presenting a complex challenge for stent-based interventions. To address this, we have developed a novel combination of stent treatments to manage this dual pathology effectively.
A 29-year-old hypertensive patient with a coarctation of the aorta and a descending thoracic aortic aneurysm was evaluated for treatment. Contrast-enhanced computed tomography angiography (CTA) revealed significant narrowing at the aortic arch (Zone 2, proximal to the left subclavian artery) with a diameter of 5.04 mm. Additionally, the descending aorta had an aneurysmal dilation measuring 29.65 mm. We applied an innovative approach combining a balloon-expandable stent (BES) with a self-expandable stent (SES). Post-procedure CTA demonstrated favourable aortic remodelling, with the narrowest point of the aorta expanding from 5.04 to 15.95 mm.
This novel technique of implanting a BES within an SES effectively addresses both the aortic coarctation and the descending aortic aneurysm. By tripling the diameter of the coarctation, the approach maximizes aortic expansion while protecting the aorta. Moreover, the combination of these stents enhances overall stability, reducing the risk of stent migration or displacement.
主动脉缩窄常与主动脉扩张相关，这给基于支架的介入治疗带来了复杂挑战。为解决这一问题，我们开发了一种新型的支架治疗组合，以有效应对这种双重病理状况。
一名29岁患有主动脉缩窄和降主动脉瘤的高血压患者接受了治疗评估。对比增强计算机断层扫描血管造影（CTA）显示主动脉弓（2区，左锁骨下动脉近端）明显狭窄，直径为5.04毫米。此外，降主动脉有一个29.65毫米的动脉瘤样扩张。我们采用了一种创新方法，将球囊扩张支架（BES）与自膨胀支架（SES）相结合。术后CTA显示主动脉重塑良好，主动脉最窄处从5.04毫米扩大到15.95毫米。
这种在SES内植入BES的新技术有效地解决了主动脉缩窄和降主动脉瘤问题。通过将缩窄处直径扩大两倍，该方法在保护主动脉的同时最大限度地实现了主动脉扩张。此外，这些支架的组合增强了整体稳定性，降低了支架迁移或移位的风险。
