Covered stents in patients with complex aortic coarctations.

ABSTRACT

BACKGROUND: There are limited data in the literature about the use of covered stent in patients with aortic coarctation. METHODS: Between January 2004 and September 2006, we implanted covered Cheatham-Platinum stents in 33 patients with complex aortic coarctation (23 men, median age 13 years, range 6-66 years). Twenty subjects had native aortic coarctation, whereas 13 had recoarctation. All procedures were performed under general anesthesia and orotracheal intubation. RESULTS: The stents used ranged from 22 to 45 mm in length. The mean fluoroscopy and procedure times were 14 +/- 6 and 74 +/- 15 minutes, respectively. After implantation, the gradient across the stenosis decreased significantly (pre stent median value 39 mm Hg [range 20-75 mm Hg] vs post stent median value 0 mm Hg [range 0-12 mm Hg] [P < .0001]). Vessel diameter increased from a median value of 5 mm (range 0-11) to a median value of 15 mm (range 10-25) (P < .0001). The stents were placed in the correct position in all subjects. No complications occurred, and on angiographic control, the stenoses had been relieved and the aneurysms completely excluded. During a median follow-up of 12 months (1-40 months), the results were stable without complications. One patient developed intrastent restenosis due to a significant endothelial proliferation that was successfully treated by high-pressure balloon angioplasty. CONCLUSIONS: Covered Cheatham-Platinum stents are promising tools for the treatment of complex aortic coarctation.