Endovascular stents for coarctation of the aorta: initial results and intermediate-term follow-up

Hamdan, Mohamed A.; Maheshwari, Sunita; Fahey, John T.; Hellenbrand, William E.

doi:10.1016/s0735-1097(01)01572-8

Cited by 225 publications

(167 citation statements)

References 26 publications

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“…However a few investigators [89,91,93,108] followed more than 20 patients for more than a mean follow-up period of 2 years. In these studies the pressure gradients across the coarctation site remained low and systemic hypertension decreased in frequency and degree with consequent decrease in antihypertensive medication use.…”

Section: Follow-up Resultsmentioning

confidence: 99%

“…Balloon rupture [91,93] may be prevented by avoiding curvature of the balloon/stent and use of newer stents with less injurious ends and by the use of BIB catheters. Because of the large sheath size, loss of pulse and bleeding from the puncture site has been reported.…”

Section: Complicationsmentioning

confidence: 99%

“…Using vascular closure devices may help circumvent this problem. Rarely reported complications include myocardial infarction and retroperitoneal hemorrhage [91,93] In a large series from the Congenital Cardiovascular Interventional Study Consortium (CCICS) database [100], reporting successful stenting of coarctation in 580 out of 588 (98.6%) cases, the complication rate was 11.7%. The complications include aneurysms in 2.2%, aortic dissection in 1.5%, stroke in 1% and death in 0.3%.…”

Section: Complicationsmentioning

confidence: 99%

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Transcatheter Stent Therapy in Children: An Update

Sahu

Rao²

2012

Pediat Therapeut

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To address elastic recoil of vessel wall and intimal dissection that can follow balloon angioplasty, stents have been designed and these appear to produce more effective relief of obstruction. Of the two types of stents, namely, balloon expandable and self expandable, balloon expandable stents are most commonly used in children. The usefulness of stents in the management of vascular obstructive lesions not amenable to balloon angioplasty is well established and has been successfully used to treat branch pulmonary artery stenosis, coarctation of the aorta, stenotic right ventricular outflow tract conduits, obstructive lesions of the systemic and pulmonary veins and others. The techniques of implantation, indications, immediate and follow-up results and complications were reviewed. The stents have also been effectively used in keeping open naturally occurring or artificially created inter-circulatory connections and as adjuncts in hybrid procedures, but these have not been discussed in this review. Future directions include investigative work on biodegradable stents and growth stents to address issues related to increase in vessel size in infants and children, use of drug eluding stents to prevent neo-intimal proliferation to avoid pulmonary vein restenosis and refinement of stent technology in hybrid procedures such as neonatal palliation of hypoplastic left heart syndrome and transcatheter completion of Fontan procedure. The feasibility, safety and effectiveness stents in the pediatric population are demonstrated, although scrutiny of results of larger experience with longer follow-up is important.

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Section: Follow-up Resultsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

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Transcatheter Stent Therapy in Children: An Update

Sahu

Rao²

2012

Pediat Therapeut

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“…4 In older patients transcatheter management with endovascular stenting is preferable to surgery in many institutions, and provides relief of pressure gradients across the coarctation site. 5 However in both circumstances patients have significant longer term risk for the development of hypertension. [6][7][8][9] Indeed, some reports claim that hypertension is the single most important long-term outcome variable in patients with repaired CoA.…”

mentioning

confidence: 99%

Hypertension and coarctation of the aorta: an inevitable consequence of developmental pathophysiology

et al. 2011

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Patients with coarctation of the aorta develop early onset hypertension in spite of early effective repair. This is associated with significant morbidity and is arguably the single most important outcome variable in this patient group. We discuss the potential pathophysiological mechanisms involved in the development of hypertension with clinical reference to monozygotic twins, and review potential strategies for therapy and prevention in this setting.

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“…This falls into a mid-range when compared with other studies of coarctation stenting (56%-88%). 5,[8][9][10][11][12][13] As this study demonstrated, complications today are uncommon and meticulous attention to detail will continue to keep rates low. We do not support a standard dose of heparin and default to a weight-based heparin load followed by activated clotting time monitoring, and we do not use the brachial artery for a second arterial access because a randomized angioplasty trial has identified brachial access with the highest rate of complications versus radial with the lowest and femoral arterial next.…”

Section: See Article By Kische Et Almentioning

confidence: 83%