Skip to main content
Erschienen in: Pediatric Cardiology 8/2013

01.12.2013 | Case Report

Percutaneous Treatment of Abdominal Coarctation in Children Using a Covered Stent

verfasst von: Mara Pilati, Giacomo Pongiglione, M. G. Gagliardi

Erschienen in: Pediatric Cardiology | Ausgabe 8/2013

Einloggen, um Zugang zu erhalten

Abstract

Coarctation of the abdominal aorta is extremely rare. It generally involves a long segment of the descending aorta and causes uncontrolled and unexplainable hypertension in children. The therapeutic choice is very challenging because acute and chronic complications are reported for both the surgical and the percutaneous approaches. The two reported cases of abdominal coarctation were treated primarily and successfully through the use of covered stents. Three covered stents were implanted in two children. No complication occurred with either procedure. At this writing, an 18-month follow-up assessment has found the patients in good health with no restenosis at the coarctation site. Covered stent implantation in children with abdominal coarctation is a feasible, safe, and effective procedure. It provides adequate relief of symptoms and reduces the risk of aneurysm formation. To avoid covering important side branches with polytetrafluoroethylene, this type of procedure must be preceded by precise study of the aorta and its branches.
Literatur
1.
Zurück zum Zitat Barral X, de Latour B, Vola M, Lacovat MP, Fichtner C, Favre JP (2006) Surgery of the abdominal aorta and its branches in children: late follow up. J Vasc Surg 43:1138–1144CrossRefPubMed Barral X, de Latour B, Vola M, Lacovat MP, Fichtner C, Favre JP (2006) Surgery of the abdominal aorta and its branches in children: late follow up. J Vasc Surg 43:1138–1144CrossRefPubMed
2.
Zurück zum Zitat Bruckheimer E, Dagan T, Amir G, Birk E (2009) Covered Cheatham-Platinum stents for serial dilation of severe native aortic coarctation. Catheter Cardiovasc Interv 74:117–121CrossRefPubMed Bruckheimer E, Dagan T, Amir G, Birk E (2009) Covered Cheatham-Platinum stents for serial dilation of severe native aortic coarctation. Catheter Cardiovasc Interv 74:117–121CrossRefPubMed
3.
Zurück zum Zitat Brzezinska-Rajszys G, Qureshi SA, Ksiazyk J et al (1999) Middle aortic syndrome treated by stent implantation. Heart 81:166–170CrossRefPubMed Brzezinska-Rajszys G, Qureshi SA, Ksiazyk J et al (1999) Middle aortic syndrome treated by stent implantation. Heart 81:166–170CrossRefPubMed
4.
5.
Zurück zum Zitat Connolly JE, Wilson SE, Lawrence PL et al (2002) Middle aortic syndrome: distal thoracic and abdominal coarctation, a disorder with multiple atiologies. J Am Coll Surg 194:774–781CrossRefPubMed Connolly JE, Wilson SE, Lawrence PL et al (2002) Middle aortic syndrome: distal thoracic and abdominal coarctation, a disorder with multiple atiologies. J Am Coll Surg 194:774–781CrossRefPubMed
6.
Zurück zum Zitat Connolly JE, Wilson SE, Lawrence PL et al (2002) Middle aortic syndrome: distal thoracic and abdominal coarctation, a disorder with multiple etiologies. J Am Coll Surg 194:774–781CrossRefPubMed Connolly JE, Wilson SE, Lawrence PL et al (2002) Middle aortic syndrome: distal thoracic and abdominal coarctation, a disorder with multiple etiologies. J Am Coll Surg 194:774–781CrossRefPubMed
7.
Zurück zum Zitat Delis KT, Gloviczki P (2005) Middle aortic syndrome: from presentation to contemporary open surgical and endovascular treatment. Perspect Vasc Surg Endovasc Ther 17:187–206CrossRefPubMed Delis KT, Gloviczki P (2005) Middle aortic syndrome: from presentation to contemporary open surgical and endovascular treatment. Perspect Vasc Surg Endovasc Ther 17:187–206CrossRefPubMed
8.
Zurück zum Zitat Fava MP, Foradori GB, Garcia CB et al (1993) Percutaneous transluminal angioplasty in patients with Takayasu’s arteritis: five-years experience. J Vasc Interv Radiol 4:649–652CrossRefPubMed Fava MP, Foradori GB, Garcia CB et al (1993) Percutaneous transluminal angioplasty in patients with Takayasu’s arteritis: five-years experience. J Vasc Interv Radiol 4:649–652CrossRefPubMed
9.
Zurück zum Zitat Giordano JM, Leavitt RY, Hoffman G, Fauci AS (1991) Experience with surgical tretament of Takayasu’s disease. Surgery 109:252–258PubMed Giordano JM, Leavitt RY, Hoffman G, Fauci AS (1991) Experience with surgical tretament of Takayasu’s disease. Surgery 109:252–258PubMed
10.
Zurück zum Zitat Gu ZM, Lin G, Yi JR et al (1988) Transluminal catheter angioplasty of abdominal aorta in Takayasu’s arteritis. Acta Radiol 29:509–513CrossRefPubMed Gu ZM, Lin G, Yi JR et al (1988) Transluminal catheter angioplasty of abdominal aorta in Takayasu’s arteritis. Acta Radiol 29:509–513CrossRefPubMed
11.
Zurück zum Zitat Kenny D, Margey R, Turner MS, Tometzki AJ, Walsh KP, Martin RP (2008) Self-expanding and balloon expandable covered stents in the treatment of aortic coarctation with or without aneurysm formation. Catheter Cardiovasc Interv 72:65–71CrossRefPubMed Kenny D, Margey R, Turner MS, Tometzki AJ, Walsh KP, Martin RP (2008) Self-expanding and balloon expandable covered stents in the treatment of aortic coarctation with or without aneurysm formation. Catheter Cardiovasc Interv 72:65–71CrossRefPubMed
12.
Zurück zum Zitat Onat T, Zeren E (1969) Coarctation of the abdominal aorta: review of 91 cases. Cardiologia 54:140–157CrossRefPubMed Onat T, Zeren E (1969) Coarctation of the abdominal aorta: review of 91 cases. Cardiologia 54:140–157CrossRefPubMed
13.
Zurück zum Zitat Park JH, Chung JW, IM J, Kim SH, Park YB, Han MC (1995) Takayasu arteritis: evaluation of mural changes in the aorta and pulmonary artery with CT angiography. Radiology 196:89–93CrossRefPubMed Park JH, Chung JW, IM J, Kim SH, Park YB, Han MC (1995) Takayasu arteritis: evaluation of mural changes in the aorta and pulmonary artery with CT angiography. Radiology 196:89–93CrossRefPubMed
14.
Zurück zum Zitat Pokrovsky AV, Sultanaliev TA, Spiridov AA (1983) Surgical treatment of vasorenal hypertension in nonspecific aorto-arteritis (Takayasu’s disease). J Cardiovasc Surg 24:111–118 Pokrovsky AV, Sultanaliev TA, Spiridov AA (1983) Surgical treatment of vasorenal hypertension in nonspecific aorto-arteritis (Takayasu’s disease). J Cardiovasc Surg 24:111–118
15.
Zurück zum Zitat Sealy WC (1976) Coarctation of the aorta and hypertension. Ann Thorac Surg 3:15–28CrossRef Sealy WC (1976) Coarctation of the aorta and hypertension. Ann Thorac Surg 3:15–28CrossRef
16.
Zurück zum Zitat Sethna CB, Kaplan BS, Cahill AM, Velazquez OC, Meyers KE (2008) Idopathic mid-aortic syndrome in children. Pediatr Nephrol 23:1135–1142CrossRefPubMed Sethna CB, Kaplan BS, Cahill AM, Velazquez OC, Meyers KE (2008) Idopathic mid-aortic syndrome in children. Pediatr Nephrol 23:1135–1142CrossRefPubMed
17.
Zurück zum Zitat Sharma S, Rajani M, Talwar KK (1992) The angiographic morphology in nonspecific aortoarteritis in the North India: an experience of 126 patients. Cardiovasc Intervent Radiol 15:160–165CrossRefPubMed Sharma S, Rajani M, Talwar KK (1992) The angiographic morphology in nonspecific aortoarteritis in the North India: an experience of 126 patients. Cardiovasc Intervent Radiol 15:160–165CrossRefPubMed
18.
Zurück zum Zitat Sharma S, Shrivastava S, Kothari SS, Kaul U, Rajani M (1994) Influence of angiographic morphology on the cute and longer-term outcome of percutaneous transluminal angioplasty in patients with aortic stenosis due to nonspecific aortitis. Cardiovasc Intervent Radiol 17:147–151PubMed Sharma S, Shrivastava S, Kothari SS, Kaul U, Rajani M (1994) Influence of angiographic morphology on the cute and longer-term outcome of percutaneous transluminal angioplasty in patients with aortic stenosis due to nonspecific aortitis. Cardiovasc Intervent Radiol 17:147–151PubMed
19.
Zurück zum Zitat Sharma S, Sharma S, Taneja K et al (1998) Morphologic mural changes in the aorta in nonspecific aortarteritis (Takayasu’s disease): assessment by intravascular ultrasound imaging. Clin Radiol 53:37–43CrossRefPubMed Sharma S, Sharma S, Taneja K et al (1998) Morphologic mural changes in the aorta in nonspecific aortarteritis (Takayasu’s disease): assessment by intravascular ultrasound imaging. Clin Radiol 53:37–43CrossRefPubMed
20.
Zurück zum Zitat Sharma S, Bahl VK, Saxena A et al (1999) Stenosis in the aorta caused by nonspecific aortitis: results of treatment by percutaneous stent placement. Clin Radiol 54:46–50CrossRefPubMed Sharma S, Bahl VK, Saxena A et al (1999) Stenosis in the aorta caused by nonspecific aortitis: results of treatment by percutaneous stent placement. Clin Radiol 54:46–50CrossRefPubMed
21.
Zurück zum Zitat Siwik ES, Perry SB, Lock JE (2003) Endovascular stent implantation in patients with stenotic aortoarteriopathies; early and medium-term results. Cathet Cardiovasc Intervent 59:380–386CrossRef Siwik ES, Perry SB, Lock JE (2003) Endovascular stent implantation in patients with stenotic aortoarteriopathies; early and medium-term results. Cathet Cardiovasc Intervent 59:380–386CrossRef
22.
Zurück zum Zitat Stanley JC et al (1981) Developmental occlusive disease of the abdominal aorta and the splanchnic and renal arteries. Am J Surg 142:190–196CrossRefPubMed Stanley JC et al (1981) Developmental occlusive disease of the abdominal aorta and the splanchnic and renal arteries. Am J Surg 142:190–196CrossRefPubMed
23.
Zurück zum Zitat Subramanayan R, Joy J, Balakrishnan KG (1989) Natural history of aortoarteritis (Takayasu’s disease). Circulation 80:429–437CrossRef Subramanayan R, Joy J, Balakrishnan KG (1989) Natural history of aortoarteritis (Takayasu’s disease). Circulation 80:429–437CrossRef
24.
Zurück zum Zitat Takagi A, Tada Y, Sato O et al (1989) Surgical treatment for Takayasu’s arteritis. J Cardiovasc Surg 30:553–558 Takagi A, Tada Y, Sato O et al (1989) Surgical treatment for Takayasu’s arteritis. J Cardiovasc Surg 30:553–558
25.
Zurück zum Zitat Trimarchi S, Tolva VS, Grassi V, Frigiola A, Carminati M, Rampoldi V (2008) Descending thoracic and abdominal aortic coarctation in the young:surgical treatment after percutaneous approaches failure. J Vasc Surg 47:865–867CrossRefPubMed Trimarchi S, Tolva VS, Grassi V, Frigiola A, Carminati M, Rampoldi V (2008) Descending thoracic and abdominal aortic coarctation in the young:surgical treatment after percutaneous approaches failure. J Vasc Surg 47:865–867CrossRefPubMed
26.
Zurück zum Zitat Tyagi S, Kaul UA, Nair M et al (1992) Balloon angioplasty of the aorta in Takayasu’s arteritis: initial and long-term results. Am Heart J 124:876–882CrossRefPubMed Tyagi S, Kaul UA, Nair M et al (1992) Balloon angioplasty of the aorta in Takayasu’s arteritis: initial and long-term results. Am Heart J 124:876–882CrossRefPubMed
27.
Zurück zum Zitat Tzifa A, Ewert P, Brzezinska-Rajskys G et al (2006) Covered Cheatham-Platinum stents for aortic coarctation: early and intermediate-term results. J Am Coll Cardiol 47:1457–1463CrossRefPubMed Tzifa A, Ewert P, Brzezinska-Rajskys G et al (2006) Covered Cheatham-Platinum stents for aortic coarctation: early and intermediate-term results. J Am Coll Cardiol 47:1457–1463CrossRefPubMed
Metadaten
Titel
Percutaneous Treatment of Abdominal Coarctation in Children Using a Covered Stent
verfasst von
Mara Pilati
Giacomo Pongiglione
M. G. Gagliardi
Publikationsdatum
01.12.2013
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 8/2013
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-013-0690-8

Weitere Artikel der Ausgabe 8/2013

Pediatric Cardiology 8/2013 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.