Erschienen in:
01.08.2003 | Clinical Investigations
Angioplasty or Stenting in Adult Coarctation of the Aorta? A
Retrospective Single Center Analysis Over a Decade
verfasst von:
Sumaira Macdonald, Steven M. Thomas, Trevor J. Cleveland, Peter A. Gaines
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 4/2003
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Abstract
For over 11 years, endovascular treatment by angioplasty (PTA) alone or stenting of adult
coarctation at a single center was evaluated. We retrospectively reviewed 28
consecutive patients (31 interventions), median age 25 years, treated
between 1991 and 2002, 20 of whom had native coarctation. Thirteen
patients had PTA alone (16 procedures) (10 “kissing balloon”
angioplasty comprising 12 interventions, and 3 single balloon
angioplasty comprising 4 interventions) and 15 patients were stented
(15 procedures), including 6 secondary and 9 primary stents. There were
no procedural or 30-day complications. For the whole group, the median
follow-up was 6.6 years (range 1–10 years). In the PTA group, median
follow-up was 9 years (range 3–10) and in the stenting group it was 3
years (range 1–5). There were 9 restenoses in the PTA group (6 after
“kissing balloons” and 3 after single balloon) comprising 56% of
the angioplasties (9/16 procedures). There was 1 restenosis in
the stenting group diagnosed at computed tomography (CT). The patient
was clinically well. For the whole group there were significant
reductions in systolic blood pressure (BP) (p = 0.0003), diastolic
BP (p = 0.004) and number of drugs per patient (p = 0.045) at
latest follow-up post-treatment. Five patients discontinued therapy.
Analysis of the groups revealed that the reduction of systolic and
diastolic BP and number of drugs did not reach statistical significance
in the PTA group but were significant in the stent group. The
endovascular management of adult coarctation is safe. Stents may be
more effective than PTA alone but longer-term follow-up of stents is
required.