Single-Center Experience With Aortic Coarctation Stenting in Adult Patients

J Invasive Cardiol. 2022 Nov;34(11):E793-E797. doi: 10.25270/jic/22.00134. Epub 2022 Oct 13.

Abstract

Objective: Endovascular repair of aortic coarctation (CoA) has become an important tool in the treatment of an expanding patient population. In this study, we present our 10-year experience with endovascular repair of CoA.

Methods: Between January 2012 and January 2022, a total of 15 patients were treated at our Institution for CoA with catheter-based techniques. Demographics, intraprocedural data, and follow-up data were retrospectively collected from institutional databases and analyzed. The primary endpoint was technical success and secondary endpoints were intraoperative complications and short-, mid-, and long-term follow-up.

Results: Mean age was 44.87 ± 15.52 years (range, 15-64) and 12 patients (80%) were male. Fourteen patients (93.3%) were hypertensive, and 4 patients (26.7%) had a bicuspid aortic valve. Three patients (20%) had undergone open repair in the pediatric age. Fourteen patients (93.3%) received stenting of CoA and 1 patient (6.7%) received thoracic endovascular aortic repair and left subclavian artery stenting for proximal pseudoaneurysmatic dilation and symptomatic restenosis. Mean pretreatment trans-stenotic gradient was 23.25 ± 11.16 mm Hg and posttreatment trans-stenotic gradient was 1.3 ± 1.33 mm Hg. Primary technical success was achieved in 15 cases (100%). One right inguinal hematoma (6.7%) was observed. One patient (6.7%) had an aortic rupture at the left subclavian artery origin after poststent dilation. Mean follow-up time was 34.75 ± 34.38 months. A total of 2 patients had an increased trans-stenotic gradient at long-term follow-up, and 1 reintervention (6.7%) for somatic growth was performed.

Conclusions: Endovascular repair of CoA is effective and safe, with excellent mid-term and long-term success rates.

Keywords: aortic coarctation; thoracic endovascular aortic repair.

MeSH terms

  • Adolescent
  • Adult
  • Aortic Coarctation* / surgery
  • Blood Vessel Prosthesis / adverse effects
  • Blood Vessel Prosthesis Implantation* / methods
  • Endovascular Procedures* / methods
  • Female
  • Hematoma / etiology
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Stents / adverse effects
  • Treatment Outcome
  • Young Adult