Use of covered stents in the treatment of aortic coarctation

Abstract

Background

The wide morphological variety of coarctation of the aorta (CoA) and some complications resulting from the implantation of conventional stents has made the utilization of covered stents (CS) desirable. We describe our experience with the use of CS to treat CoA in children and adults.

Methods

The records of patients that received CS were retrospectively reviewed. The procedures were performed according to the established technique. Use of CS as primary treatment were assessed, as well as those deployed due to complications resulting from the initial procedure.

Results

Between 2007 and 2014, CS were used in 14 patients, 9 (64.3%) of whom were males. The mean age was 19.5 ± 10.5 years, and the mean weight 61.7 ± 25.5 kg. Bicuspid aortic valve was present in 74% of cases, and two patients had patent ductus arteriosus. Subatretic aortic coarctations were found in five patients. Eleven patients had systemic arterial hypertension, and 73% had normalized blood pressure levels after stent dilation. Implantation was possible in all cases. Primary implants were performed in ten (71.4%) patients with native coarctation and in four patients as a second device to correct problems originating from previous procedures. The mean time of follow-up was 51.7 ± 29.8 months. Three minor complications were related to procedures, and there were no deaths.

Conclusions

The use of CS was safe and effective in this small case series. Further studies focusing on the long-term evolution and the possibility of CS redilation are needed to support its use in children.