What are the long-term outcomes of stents in coarctation of the aorta (CoA) repair?

Updated: Nov 20, 2018
  • Author: Syamasundar Rao Patnana, MD; Chief Editor: Stuart Berger, MD  more...
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Most studies had only a short-term and incomplete follow-up in a limited number of patients. However, a few studies examined results of more than 20 patients at a mean follow-up of 2 years or longer. [106, 109, 112, 113, 123] The pressure gradients across the coarctation site (blood pressure, Doppler, or catheterization) remained low, and systemic hypertension decreased both in degree and frequency with the consequent decrease in the need for antihypertensive medications. No evidence for recoarctation, aneurysmal formation, or stent fracture or displacement was observed in most studies, although no systematic or complete follow-up was achieved in most studies. In some studies new aneurysms (in 6% of patients), stent fractures and jailed or partially covered brachiocephalic vessels were seen. [126]

Residual or recurrent obstruction was present in a few patients, and, in these, successful redilatation with larger balloons was accomplished. Detailed angiographic studies by Suarez de Lezo et al (1999) revealed no detectable neointimal proliferation in 75% of patients; in the remaining patients, focal neointimal ridge formation was observed at the ends of the stent, causing minimal restenosis. [106] Segmental analysis of the aorta revealed an increase in nonstented segments of the aorta, consistent with normal growth. Two young patients (7%) developed small new aneurysms that were obliterated by coil placement following angiographic detection. However, the overall follow-up results were encouraging.

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