Covered stent placement for treatment of coarctation of the aorta: immediate and long-term results.

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MARC

Stassen, Jan (author)

Covered stent placement for treatment of coarctation of the aorta: immediate and long-term results.

Article/chapterEnglish2021

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2020-10-28
Informa UK Limited,2021

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LIBRIS-ID:oai:gup.ub.gu.se/297431
https://gup.ub.gu.se/publication/297431URI
https://doi.org/10.1080/00015385.2020.1838126DOI

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Language:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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This study aimed to describe the safety and efficacy of covered stents in patients with coarctation of aorta (CoA) for immediate and long-term follow-up.Covered stents are increasingly being used in (re)CoA, mainly to reduce the risk of aortic wall injuries (AWI). However, limited data are available on intermediate and long-term outcome.In 89 patients (67.4% male) with a mean age of 23.9±15.8 (min max range 5.1-71.6) years were 102 covered stents implanted (January 2003 - December 2017). Short-term pre/post-implant hemodynamics and angiographic data were reported. Changes in blood pressure, the use of antihypertensive drugs and complications were recorded during follow-up.The procedural success rate was 100%. The mean invasive ascending-to-descending aorta systolic gradient under general anaesthesia decreased from 25±16mmHg to 4±7mmHg (p<0.001). After a mean follow-up time of 6.6±3.7years, there was a persistent improvement of the mean systolic blood pressure gradient between right arm and leg (-7±18 vs 38±24mmHg; p<0.001). A larger proportion of patients required antihypertensive medication (33.7% vs 50.0%, p=0.017) and needed ≥ 2 drugs (20.2% vs 27.4%, p=0.066) to control blood pressure. Long-term adverse events were found in 4.5% of patients [covered stent fracture (n=3), aneurysm formation (n=2)].Covered stent implantation for CoA is highly successful, safe and results in a persistent hemodynamic improvement in the immediate and long-term outcome. Lifelong follow-up with additional antihypertensive drug treatment is mandatory to maintain favourable hemodynamic results after stenting.Long-term follow-up data on covered stents in patients with coarctation of the aorta are scarce. A cohort of 89 patients was reviewed. The procedural implantation success rate was 100%. The invasive gradient decreased from 25±16mmHg to 4±7mmHg (p<0.001). After follow-up of 6.6±3.7years, there was a persistent improvement of the clinical systolic blood pressure gradient (-7±18 vs 38±24mmHg; p<0.001). However, a larger proportion of patients required antihypertensive medication (33.7% vs 50.0%, p=0.017). Covered stent implantation results in favourable hemodynamic effects, but lifelong follow-up with additional antihypertensive drug treatment is mandatory to maintain these results.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences hsv//eng

Added entries (persons, corporate bodies, meetings, titles ...)

De Meester, Pieter (author)
Troost, Els (author)
Roggen, Leen (author)
Moons, Philip,1968Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences(Swepub:gu)xmooph (author)
Gewillig, Marc (author)
Van De Bruaene, Alexander (author)
Budts, Werner (author)
Göteborgs universitetInstitutionen för vårdvetenskap och hälsa (creator_code:org_t)

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In:Acta cardiologica: Informa UK Limited76:5, s. 464-4721784-973X0001-53850373-7934

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences

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By the university: University of Gothenburg

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