From Bare to Covered. Issue 6 (4th February 2014)

• Record Type: Journal Article
• Authors: Butera, Gianfranco; Manica, João Luiz Langer; Marini, Davide; Piazza, Luciane; Chessa, Massimo; Filho, Raul Ivo Rossi; Sarmento Leite, Rogério E.; Carminati, Mario
• Is Part Of: Catheterization and cardiovascular interventions. Volume 83:Issue 6(2014:May 01)
• Page Start: 953
• Page End: 963
• Publication Date: 2014-02-04
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25404
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25404-sec-0001" sec-type="section"> <title>Background</title> <p>Bare stents has become the first line therapy for aortic coarctation. Covered stents has been reported more recently in clinical practice.</p> </sec> <sec id="ccd25404-sec-0002" sec-type="section"> <title>Objectives</title> <p>The present study, reports comparatively 15‐year experience of bare and covered stent implantation for aortic coarctation in a single tertiary referral center.</p> </sec> <sec id="ccd25404-sec-0003" sec-type="section"> <title>Methods</title> <p>From 1997 to 2011, 143 patients with native or postoperative aortic coarctation were treated at our institution. Seventy‐one subjects (median age 17 years (range from 4 to 70 years) underwent bare stent implantation (Group 1) while 72 patients (median age of 17.5 years (range from 6 to 68 years) underwent covered stent implantation (Group 2).</p> </sec> <sec id="ccd25404-sec-0004" sec-type="section"> <title>Results</title> <p>Success rate in the whole group was 95%. More complex and tighter coarctations were treated using covered stents. Incidence of related‐procedure adverse events was higher in Group 1 than in group 2 (21.1% vs. 8.3% <italic>P</italic> = 0.035). Aortic wall complications occurred in 7% of patients in Group 1 (one death) and 0% in Group 2 (<italic>P</italic> = 0.028). Subjects in Group 1 had a longer follow‐up (median 85 vs. 35 months; <italic>P</italic> < 0.001). Independent predictors associated with reintervention included the presence of complex lesions (HR: 2.70; CI: 1.15–6.32), balloon diameter used <14 mm (HR: 3.76; CI: 1.48–9.55), and immediate residual gradient >10 mm Hg (HR: 4.30; CI: 1.96–9.47).</p> </sec> <sec id="ccd25404-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Both bare and covered stent implantation for aortic coarctation is a safe and efficacious treatment. By using covered stent implantation the spectrum of patients treated has increased with lower rates of acute and late complications. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>