From bare to covered: 15-year single center experience and follow-up in trans-catheter stent implantation for aortic coarctation.

Abstract

BACKGROUND:

Bare stents has become the first line therapy for aortic coarctation. Covered stents has been reported more recently in clinical practice.

OBJECTIVES:

The present study, reports comparatively 15-year experience of bare and covered stent implantation for aortic coarctation in a single tertiary referral center.

METHODS:

From 1997 to 2011, 143 patients with native or postoperative aortic coarctation were treated at our institution. Seventy-one subjects (median age 17 years (range from 4 to 70 years) underwent bare stent implantation (Group 1) while 72 patients (median age of 17.5 years (range from 6 to 68 years) underwent covered stent implantation (Group 2).

RESULTS:

Success rate in the whole group was 95%. More complex and tighter coarctations were treated using covered stents. Incidence of related-procedure adverse events was higher in Group 1 than in group 2 (21.1% vs. 8.3% P = 0.035). Aortic wall complications occurred in 7% of patients in Group 1 (one death) and 0% in Group 2 (P = 0.028). Subjects in Group 1 had a longer follow-up (median 85 vs. 35 months; P < 0.001). Independent predictors associated with reintervention included the presence of complex lesions (HR: 2.70; CI: 1.15-6.32), balloon diameter used <14 mm (HR: 3.76; CI: 1.48-9.55), and immediate residual gradient >10 mm Hg (HR: 4.30; CI: 1.96-9.47).

CONCLUSIONS:

Both bare and covered stent implantation for aortic coarctation is a safe and efficacious treatment. By using covered stent implantation the spectrum of patients treated has increased with lower rates of acute and late complications.

• Authors: Gianfranco Butera, João Luiz Langer Manica, Davide Marini, Luciane Piazza, Massimo Chessa, Raul Ivo Rossi Filho, Rogério E Sarmento Leite, Mario Carminati
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 83 Issue 6 Pg. 953-63 (May 01 2014) ISSN: 1522-726X [Electronic] United States
• PMID: 24459104 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Wiley Periodicals, Inc.

Topics

• Adolescent
• Adult
• Aged
• Aortic Coarctation (diagnosis, therapy)
• Aortography
• Child
• Child, Preschool
• Endovascular Procedures (adverse effects, instrumentation)
• Female
• Humans
• Italy
• Male
• Middle Aged
• Prosthesis Design
• Retreatment
• Retrospective Studies
• Risk Factors
• Stents
• Tertiary Care Centers
• Time Factors
• Treatment Outcome
• Young Adult