STENTING FOR PERIPHERAL PULMONARY-ARTERY STENOSES

Four patients (3 with surgically corrected tetralogy of Fallot and 1 w ith atrial septal defect) received 6 stents for peripheral pulmonary a rtery stenoses. In 3 patients, stenting was performed for inadequate r esults of balloon dilatation (elastic recoil in 2 and incomplete dilat ation in 1). One patient received a stent without prior angioplasty. T hree Palmaz-Schatz stents (6-14 mm diameter, 15-30 mm length) and 3 St recker stents (7-9 mm diameter, 40 mm length) were used. The procedure was successful in 2 cases, in whom pulmonary artery pressures dropped from a peak of 90 and 94 mm Hg, to 60 and 30 mm Hg, respectively. Tra nslesional gradients diminished from 78 to 20 mm Hg and 90 to 10 mm Hg , respectively, and pulmonary perfusion scintigraphy revealed an incre ase in perfusion of the affected lung from 28% to 49% and 22% to 46%, respectively. In 1 patient stenting was only partially successful due to incomplete expansion and distal migration of a Strecker stent in a pressure resistant stenosis. In another patient stenting failed for th e same reason. Stenting for peripheral pulmonary artery stenoses may b e effective, but has to be restricted to lesions which yield to prior balloon dilatation.