Purpose: The efficacy and safety of endovascular stent implantation to corr
ect dissection or a suboptimal result after percutaneous transluminal angio
plasty (PTA) was evaluated in patients suffering from aortic stenosis due t
o aortoarteritis.
Methods: Twelve children and young adults [aged (mean +/- SD) 18.2 +/- 8.7
years] underwent stent implantation after PTA of the aorta, seven for obstr
uctive dissection, four for ineffective balloon dilatation, and one for rec
urrent restenosis. Nine patients underwent implantation of self-expandable
stents and three received balloon-expandable Palmaz stents.
Results: Stent implantation could be successfully performed in all 12 patie
nts. After stent implantation, the peak systolic pressure gradient decrease
d from 91 +/- 33.5 mmHg to 12.4 +/- 12.5 mmHg (p < 0.001). The diameter of
the stenosed segment increased from 4.6 +/- 0.8 mm to 11.1 +/- 1.9 mm (p <
0.001). The dissection was completely covered in all seven patients with di
ssection. Except for epigastric pain with vomiting in one patient, there wa
s no complication. On follow-up, over 12-57 months (mean 26.8 +/- 10.8 mont
hs), 11 patients (91.6%) had marked improvement in their blood pressure. Pa
tients with congestive heart failure and claudication also showed improveme
nt. Repeat catheterization in five patients, between 6-30 months (mean 16.8
+/- 9.1 months) after stent implantation, showed sustained improvement in
four and a fusiform, long segment, intrastent restenosis after 30 months in
one child. The stenosis was safely redilated.
Conclusion: Endovascular aortic stent implantation is safe and provides goo
d immediate relief in patients with unsatisfactory results after balloon an
gioplasty. Improvement is sustained in most patients on intermediate-term f
ollow-up.