PMID: 20635738Jul 20, 2010Paper

Endovascular stenting for native coarctation in older children and adolescents using adult self-expanding (Nitinol) iliac stents

Indian Heart Journal
Amar N PatnaikD S Rao

Abstract

The role of balloon-expandable stents for native coarctation has been proven in several small studies. Use of Nitinol-made self-expanding stents in such situations is reported in adults in only a few cases. For the last 5 years we used self expanding nitinol stents (primarily recommended for iliac angioplasty in adults in this condition in older children. There were 32 patients in total (24 males; mean age 10.2 +/- 1.43 years; youngest 6-years-old). Successful procedure is defined as reduction of gradient to less than 20 mmHg or increase in the ratio of the diameter of the coarctation area to the diameter of the descending aorta to at least 0.8. Bard luminexx vascular stents were used in all cases. In 32 patients 32 stents were used with overall success rate of 31/32 (96.8%). The peak systolic pressure gradient (mean (SD) decreased from 48.8 (23.5) to 2.2 (1.86) mm Hg (p<0.05). The diameter of the stenotic lesion increased from 5.6 (1.6) mm to 12.5 (2.6) (p<0.05). In one patient 2 stents were used because the first stent migrated downwards leaving the lesion partially uncovered. Nitinol stents were easier to deploy and conformed well to aortic walls. In the only unsuccessful case, the lesion was 12 mm long, tubular and did not ...Continue Reading

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