What is the role of aortic stents in the repair of coarctation of the aorta (CoA)?

Updated: Nov 20, 2018
  • Author: Syamasundar Rao Patnana, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

Vascular stenotic lesions can be opened with balloon angioplasty, but, because of the elastic recoil of the vessel wall, the vessel lumen may return to the predilation size following withdrawal of the balloon catheter. Such recoil and vascular dissection following balloon dilatation can be circumvented with implantation of endovascular stents. Dotter (1969), in the late 1960s, suggested this concept and implanted spiral coil-spring prostheses into the experimentally produced peripheral artery stenotic lesions. The stent concept and technology were dormant until the early 1980s, when the balloon-expandable and self-expanding stents were designed and used. [96] Initially, stents were used in the treatment of peripheral arterial disease and coronary artery stenotic lesions in adults. The technique was then extended to the treatment of other stenotic vessels, including aortic coarctation. [61, 97]

Despite reasonably good short-term and long-term results of balloon angioplasty, some problems remain, including restenosis, probability of aortic rupture, formation of aneurysms, and inability to effectively treat long-segment tubular narrowing. Because of these and other reasons, endovascular stenting of aortic coarctation has gained acceptance over the last decade. [60, 91, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119]


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