Korean Circ J.  2009 Jul;39(7):261-263. 10.4070/kcj.2009.39.7.261.

Use of Covered Stents to Treat Coarctation of the Aorta

• Qureshi SA

• KMID: 2145560
• DOI: http://doi.org/10.4070/kcj.2009.39.7.261

Abstract

Transcatheter treatments for coarctation of the aorta include balloon angioplasty and stent implantation. However, balloon angioplasty has its limitations and may be associated with complications, such as, recoarctation, dissection, and aneurysm formation, in adult patients. Bare metal stent implantation has offered an alternative during the last decade or so, but covered stents have been used with increasing frequency more recently, to the extent that covered stent implantation is the preferred treatment in correctly selected patients. Primary stent insertion, whether bare metal or covered, prevents elastic recoil of the aorta and may provide better and more predictable results than balloon angioplasty. Furthermore, stents are preferable for the treatment of complex aortic arch obstructions, but their usage is limited to older patients, because of limitations associated with growth.

Keyword

Aortic coarctation; Stents

MeSH Terms

Adult
Aneurysm
Angioplasty, Balloon
Aorta
Aorta, Thoracic
Aortic Coarctation
Humans
Stents

Reference

1. English KM. Stenting the mildly obstructive aortic arch: useful treatment or oculo-inflatory reflex? Heart. 2006. 92:1541–1543.

2. Connolly JE. Hume memorial lecture: prevention of spinal cord complications in aortic surgery. Am J Surg. 1998. 176:92–101.

3. Bouchart F, Dubar A, Tabley A, et al. Coarctation of the aorta in adults: surgical results and long term follow up. Ann Thorac Surg. 2000. 70:1483–1488.

4. Lock JE, Castaneda-Zuniga WR, Bass JL, Foker JE, Amplatz K, Anderson RW. Balloon dilation of excised aortic coarctations. Radiology. 1982. 143:689–691.

5. Isner JM, Donaldson RF, Fulton D, Bhan I, Payne DD, Cleveland RJ. Cystic medial necrosis in coarctation of the aorta: a potential factor contributing to adverse consequences observed after percutaneous balloon angioplasty of coarctation sites. Circulation. 1987. 75:689–695.

6. Ohkubo M, Takahashi K, Kishiro M, Akimoto K, Yamashiro Y. Histological findings after angioplasty using conventional balloon, radiofrequency thermal balloon and stent for experimental aortic coarctation. Pediatr Int. 2004. 46:39–47.

7. O'Laughlin MP, Perry SB, Lock JE, Mullins CE. Use of endovascular stents in congenital heart disease. Circulation. 1991. 83:1923–1939.

8. Magee AG, Brzezinska-Rajszys G, Qureshi SA, et al. Stent implantation for aortic coarctation and re-coarctation. Heart. 1999. 82:600–606.

9. Thanopoulos BD, Hadjinikolaou L, Konstadopoulou GN, Tsaousis GS, Triposkiadis F, Spirou P. Stent treatment for coarctation of the aorta: intermediate-term follow-up and technical considerations. Heart. 2000. 84:65–70.

10. Forbes TJ, Garekar S, Amin Z, et al. Procedural results and acute complications in stenting native and recurrent coarctation of the aorta in patients over 4 years of age: a multi-institutional study. Catheter Cardiovasc Interv. 2007. 70:276–285.

11. Forbes TJ, Moore P, Pedra CA, et al. Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta. Catheter Cardiovasc Interv. 2007. 70:569–577.

12. Ewert P, Schubert S, Peters B, Abdul-Khaliq H, Nagdyman N, Lange PE. The CP--stent, short, long, covered--for the treatment of aortic coarctation, stenosis of pulmonary arteries and caval veins, and Fontan anastomosis in children and adults: an evaluation of 60 stents in 53 patients. Heart. 2005. 91:948–953.

13. Tzifa A, Ewert P, Brzezinska-Rajszys G, et al. Covered Cheatham-platinum stents for aortic coarctation: early and intermediate-term results. J Am Coll Cardiol. 2006. 47:1457–1463.

14. Butera G, Piazza L, Chessa M, et al. Covered stents in patients with congenital heart defects. Catheter Cardiovasc Interv. 2006. 67:466–472.

15. Duggal B, Radhakrishnan S, Mathur A, Khurana P, Shrivastava S. Covered stents deployed for coarctation of aorta with aneurysm. Indian Heart J. 2005. 57:346–349.

16. Gunn J, Cleveland T, Gaines P. Covered stent to treat co-existent coarctation and aneurysm of the aorta in a young man. Heart. 1999. 82:351.

17. Khan MS, Moore JW. Treatment of abdominal aortic pseudoaneurysm with covered stents in a pediatric patient. Catheter Cardiovasc Interv. 2000. 50:445–448.

18. de Giovanni JV. Covered stents in the treatment of aortic coarctation. J Interv Cardiol. 2001. 14:187–190.

19. Forbes T, Matisoff D, Dysart J, Aggarwal S. Treatment of coexistent coarctation and aneurysm of the aorta with covered stent in a pediatric patient. Pediatr Cardiol. 2003. 24:289–291.

20. Sadiq M, Malick NH, Qureshi SA. Simultaneous treatment of native coarctation of the aorta combined with patent ductus arteriosus using a covered stent. Catheter Cardiovasc Interv. 2003. 59:387–390.

21. Kulkarni S, Vimala J, Parmar R. Single therapeutic catheterization for treatment of native coarctation of aorta and large patent ductus arteriosus using a covered stent. Indian Heart J. 2005. 57:713–716.

22. Qureshi SA, Zubrzycka M, Brzezinska-Rajszys G, Kosciesza A, Ksiazyk J. Use of covered Cheatham-Platinum stents in aortic coarctation and recoarctation. Cardiol Young. 2004. 14:50–54.

23. Wilson N. Transcatheter therapy of long extreme subatretic aortic coarctations with covered stents: a logical solution for an extreme situation: the stress of pressure and fatigue--a roblem for the cardiologist or for the stent? Catheter Cardiovasc Interv. 2004. 63:240–241.

24. Ewert P, Abdul-Khaliq H, Peters B, Nagdyman N, Schubert S, Lange PE. Transcatheter therapy of long extreme subatretic aortic coarctations with covered stents. Catheter Cardiovasc Interv. 2004. 63:236–239.

25. Almashham Y, Dahdah N, Miro J. Use of radiofrequency then stent implantation for recanalization of complete aorta coarctation. Pediatr Cardiol. 2008. 29:207–209.

26. Pedra CA, Fontes VF, Esteves CA, et al. Use of covered stents in the management of coarctation of the aorta. Pediatr Cardiol. 2005. 26:431–439.

27. Butera G, Gaio G, Carminati M. Redilation of e-PTFE covered CP stents. Catheter Cardiovasc Interv. 2008. 72:273–277.

28. Collins N, Mahadevan V, Horlick E. Aortic rupture following a covered stent for coarctation: delayed recognition. Catheter Cardiovasc Interv. 2006. 68:653–655.

29. Tanous D, Collins N, Dehghani P, Benson LN, Horlick EM. Covered stents in the management of coarctation of the aorta in the adult: initial results and 1-year angiographic and hemodynamic follow-up. Int J Cardiol. 2008. [Epub ahead of print].

30. Kay JD, Chan KC. Aortic pseudo aneurysm complicating coarctation stenting successfully treated with a PTFE balloon expandable covered stent. Congenit Heart Dis. 2008. 3:209–212.

31. Kenny D, Margey R, Turner MS, Tometzki AJ, Walsh KP, Martin RP. Self-expanding and balloon expandable covered stents in the treatment of aortic coarctation with or without aneurysm formation. Catheter Cardiovasc Interv. 2008. 72:65–71.

32. Mitchell RS, Miller DC, Dake MD. Stent-graft repair of thoracic aortic aneurysms. Semin Vasc Surg. 1997. 10:257–271.

33. Waltham M, Agrawal V, Bowman L, Hughes C, White GH. Right arm ischemia following intentional stent-graft coverage of an anomalous right subclavian artery. J Endovasc Ther. 2005. 12:110–114.