IMPLANTATION OF BALLOON-EXPANDABLE STENTS FOR COARCTATION OF THE AORTA - IMPLANTATION DATA AND SHORT-TERM RESULTS

We report the immediate results and the short-term follow-up in a grou p of selected patients with coarctation of the aorta who underwent end ovascular stent implantation. Balloon-expandable stents were implanted in 6 patients (mean age 19.8 +/- 5.1 years) with coarctation of the a orta (4 recurrent and 2 native) who underwent a total of 7 procedures (6 implantation and 1 further expansion). The systolic peak pressure g radient was decreased from 36.7 +/- 16.9 to 13.3 +/- 23.2 mm Hg (P < 0 .005). There was a 66% increase in the mean coarctation diameter from 9.3 +/- 1.7 to 15.6 +/- 3.1 mm (P = 0.001) with the ratio of the coarc tation to descending aorta diameter, measured at the level of the diap hragm, increasing from 0.49 +/- 0.1 to 0.81 +/- 0.2 (P < 0.005). The d ilatation was successful in expanding the stent to an acceptable diame ter in 5 of 6 patients. One patient underwent successful further expan sion of a stent implanted 22 months previously. There were no immediat e complications during balloon expansion and stent implantation. One p atient suffered a femoral arterial bleed requiring surgical repair. Th ere was one unrelated death. All patients were hypertensive (systolic blood pressure >140 mm Hg) prior to stent implantation. At mean follow -up of 8 months, 3 patients are normotensive. There was no recurrence of coarctation, aortic dissection, or aneurysm formation in the patien ts in whom stent implantation was successful. These findings indicate that balloon-expandable stent implantation for coarctation of the aort a in selected patients is a safe and effective alternative approach fo r relieving the obstruction with a low complication rate and no recoar ctation at short-term follow-up. (C) 1996 Wiley-Liss, Inc.