Balloon dilation was introduced in 1982 as an alternative to surgery. Since then, balloon-expandable endovascular stents have been used successfully to treat large vessel stenoses. Dilation angioplasty with a stent creates a controlled tear in the aortic wall supported by the stent framework, minimizing risk of dissection or aneurysm formation that could occur with balloon dilation alone.
Some clinicians consider stent placement to be treatment of choice for aortic coarctation (native or recurrent) in older children and adults. .
Endovascular stents for coarct
Studies have shown excellent results in short and intermediate follow-up with success rates approaching 97% in selected patients.
Complications of stent placement are generally well tolerated and rarely serious. These include: arterial access problems, stent migration, aneurysm formation and late restenosis due to intimal hyperplasia.
Some stents can be re-dilated up to 3 years after implantation to accommodate somatic growth. The widespread use of stents in young patients is limited by the large sheath size required for placement. To date, long-term follow-up studies have not been published.
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References:
1) Hamdan MA et al., Endovascular stents for coarctation of the aorta: initial results and intermediate-term follow up. (Circulation supplement 2000,102(18):II-466)
2) Ovaert C et al., Transcatheter treatment of coarctation of the aorta: a review. Pediatric Cardiology 1998;19:27-44
3) De Lezo JS et al., Immediate and follow-up findings after stent treatment for severe coarctation of the aorta. Am J Cardiol 1999;83:400-406
4) O Laughlin MP et al., Implantation and intermediate-term follow-up of stents in congenital heart disease. Circulation 1993;88:605-14.
