Covered stents in patients with complex aortic coarctations

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.