Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta

Thomas J. Forbes; Phillip Moore; Carlos A.C. Pedra; Evan M. Zahn; David Nykanen; Zahid Amin; Swati Garekar; David Teitel; Shakeel A. Qureshi; John P. Cheatham; Makram R. Ebeid; Ziyad M. Hijazi; Satinder Sandhu; Donald J. Hagler; Horst Sievert; Thomas E. Fagan; Jeremy Ringwald; Wei Du; Liwen Tang; David F. Wax; John Rhodes; Troy A. Johnston; Thomas K. Jones; Daniel R. Turner; Robert Pass; Alejandro Torres; William E. Hellenbrand

doi:10.1002/ccd.21191

Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta

Thomas J. Forbes, Phillip Moore, Carlos A.C. Pedra, Evan M. Zahn, David Nykanen, Zahid Amin, Swati Garekar, David Teitel, Shakeel A. Qureshi, John P. Cheatham, Makram R. Ebeid, Ziyad M. Hijazi, Satinder Sandhu, Donald J. Hagler, Horst Sievert, Thomas E. Fagan, Jeremy Ringwald, Wei Du, Liwen Tang, David F. WaxJohn Rhodes, Troy A. Johnston, Thomas K. Jones, Daniel R. Turner, Robert Pass, Alejandro Torres, William E. Hellenbrand

Research output: Contribution to journal › Article › peer-review

153 Scopus citations

Abstract

Background: We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques. Methods and Results: Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005. About 27% (160/588) procedures were followed up by further IAI of their aorta (MRI/CT/repeat cardiac catheterization) after initial stent procedures. Abnormal imaging studies included: the presence of dissection or aneurysm formation, stent fracture, or the presence of reobstruction within the stent (instent restenosis or significant intimal build-up within the stent). Forty-one abnormal imaging studies were reported in the intermediate follow-up at median 12 months (0.5-92 months). Smaller postintervention of the aorta (CoA) diameter and an increased persistent systolic pressure gradient were associated with encountering abnormal follow-up imaging studies. Aortic wall abnormalities included dissections (n = 5) and aneurysm (n = 13). The risk of encountering aortic wall abnormalities increased with larger percent increase in CoA diameter poststent implant, increasing balloon/coarc ratio, and performing prestent angioplasty. Stent restenosis was observed in 5/6 parts encountering stent fracture and neointimal buildup (n = 16). Small CoA diameter poststent implant and increased poststent residual pressure gradient increased the likelihood of encountering instent restenosis at intermediate follow-up. Conclusions: Abnormalities were observed at intermediate follow-up following IS placement for treatment of native and recurrent coarctation of the aorta. Not exceeding a balloon:coarctation ratio of 3.5 and avoidance of prestent angioplasty decreased the likelihood of encountering an abnormal follow-up imaging study in patients undergoing intravascular stent placement for the treatment of coarctation of the aorta. We recommend IAI for all patients undergoing IS placement for treatment of CoA.

Original language	English (US)
Pages (from-to)	569-577
Number of pages	9
Journal	Catheterization and Cardiovascular Interventions
Volume	70
Issue number	4
DOIs	https://doi.org/10.1002/ccd.21191
State	Published - Oct 1 2007
Externally published	Yes

Keywords

Coarctation
Intermediate complications
Intravascular stent

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

Access to Document

10.1002/ccd.21191

Cite this

Forbes, T. J., Moore, P., Pedra, C. A. C., Zahn, E. M., Nykanen, D., Amin, Z., Garekar, S., Teitel, D., Qureshi, S. A., Cheatham, J. P., Ebeid, M. R., Hijazi, Z. M., Sandhu, S., Hagler, D. J., Sievert, H., Fagan, T. E., Ringwald, J., Du, W., Tang, L., ... Hellenbrand, W. E. (2007). Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta. Catheterization and Cardiovascular Interventions, 70(4), 569-577. https://doi.org/10.1002/ccd.21191

Forbes, TJ, Moore, P, Pedra, CAC, Zahn, EM, Nykanen, D, Amin, Z, Garekar, S, Teitel, D, Qureshi, SA, Cheatham, JP, Ebeid, MR, Hijazi, ZM, Sandhu, S, Hagler, DJ, Sievert, H, Fagan, TE, Ringwald, J, Du, W, Tang, L, Wax, DF, Rhodes, J, Johnston, TA, Jones, TK, Turner, DR, Pass, R, Torres, A & Hellenbrand, WE 2007, 'Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta', Catheterization and Cardiovascular Interventions, vol. 70, no. 4, pp. 569-577. https://doi.org/10.1002/ccd.21191

@article{17a3eb4bd35e4d859b9a6a2a67168ac8,

title = "Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta",

abstract = "Background: We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques. Methods and Results: Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005. About 27% (160/588) procedures were followed up by further IAI of their aorta (MRI/CT/repeat cardiac catheterization) after initial stent procedures. Abnormal imaging studies included: the presence of dissection or aneurysm formation, stent fracture, or the presence of reobstruction within the stent (instent restenosis or significant intimal build-up within the stent). Forty-one abnormal imaging studies were reported in the intermediate follow-up at median 12 months (0.5-92 months). Smaller postintervention of the aorta (CoA) diameter and an increased persistent systolic pressure gradient were associated with encountering abnormal follow-up imaging studies. Aortic wall abnormalities included dissections (n = 5) and aneurysm (n = 13). The risk of encountering aortic wall abnormalities increased with larger percent increase in CoA diameter poststent implant, increasing balloon/coarc ratio, and performing prestent angioplasty. Stent restenosis was observed in 5/6 parts encountering stent fracture and neointimal buildup (n = 16). Small CoA diameter poststent implant and increased poststent residual pressure gradient increased the likelihood of encountering instent restenosis at intermediate follow-up. Conclusions: Abnormalities were observed at intermediate follow-up following IS placement for treatment of native and recurrent coarctation of the aorta. Not exceeding a balloon:coarctation ratio of 3.5 and avoidance of prestent angioplasty decreased the likelihood of encountering an abnormal follow-up imaging study in patients undergoing intravascular stent placement for the treatment of coarctation of the aorta. We recommend IAI for all patients undergoing IS placement for treatment of CoA.",

keywords = "Coarctation, Intermediate complications, Intravascular stent",

author = "Forbes, {Thomas J.} and Phillip Moore and Pedra, {Carlos A.C.} and Zahn, {Evan M.} and David Nykanen and Zahid Amin and Swati Garekar and David Teitel and Qureshi, {Shakeel A.} and Cheatham, {John P.} and Ebeid, {Makram R.} and Hijazi, {Ziyad M.} and Satinder Sandhu and Hagler, {Donald J.} and Horst Sievert and Fagan, {Thomas E.} and Jeremy Ringwald and Wei Du and Liwen Tang and Wax, {David F.} and John Rhodes and Johnston, {Troy A.} and Jones, {Thomas K.} and Turner, {Daniel R.} and Robert Pass and Alejandro Torres and Hellenbrand, {William E.}",

year = "2007",

month = oct,

day = "1",

doi = "10.1002/ccd.21191",

language = "English (US)",

volume = "70",

pages = "569--577",

journal = "Catheterization and Cardiovascular Interventions",

issn = "1522-1946",

publisher = "Wiley-Liss Inc.",

number = "4",

}

TY - JOUR

T1 - Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta

AU - Forbes, Thomas J.

AU - Moore, Phillip

AU - Pedra, Carlos A.C.

AU - Zahn, Evan M.

AU - Nykanen, David

AU - Amin, Zahid

AU - Garekar, Swati

AU - Teitel, David

AU - Qureshi, Shakeel A.

AU - Cheatham, John P.

AU - Ebeid, Makram R.

AU - Hijazi, Ziyad M.

AU - Sandhu, Satinder

AU - Hagler, Donald J.

AU - Sievert, Horst

AU - Fagan, Thomas E.

AU - Ringwald, Jeremy

AU - Du, Wei

AU - Tang, Liwen

AU - Wax, David F.

AU - Rhodes, John

AU - Johnston, Troy A.

AU - Jones, Thomas K.

AU - Turner, Daniel R.

AU - Pass, Robert

AU - Torres, Alejandro

AU - Hellenbrand, William E.

PY - 2007/10/1

Y1 - 2007/10/1

N2 - Background: We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques. Methods and Results: Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005. About 27% (160/588) procedures were followed up by further IAI of their aorta (MRI/CT/repeat cardiac catheterization) after initial stent procedures. Abnormal imaging studies included: the presence of dissection or aneurysm formation, stent fracture, or the presence of reobstruction within the stent (instent restenosis or significant intimal build-up within the stent). Forty-one abnormal imaging studies were reported in the intermediate follow-up at median 12 months (0.5-92 months). Smaller postintervention of the aorta (CoA) diameter and an increased persistent systolic pressure gradient were associated with encountering abnormal follow-up imaging studies. Aortic wall abnormalities included dissections (n = 5) and aneurysm (n = 13). The risk of encountering aortic wall abnormalities increased with larger percent increase in CoA diameter poststent implant, increasing balloon/coarc ratio, and performing prestent angioplasty. Stent restenosis was observed in 5/6 parts encountering stent fracture and neointimal buildup (n = 16). Small CoA diameter poststent implant and increased poststent residual pressure gradient increased the likelihood of encountering instent restenosis at intermediate follow-up. Conclusions: Abnormalities were observed at intermediate follow-up following IS placement for treatment of native and recurrent coarctation of the aorta. Not exceeding a balloon:coarctation ratio of 3.5 and avoidance of prestent angioplasty decreased the likelihood of encountering an abnormal follow-up imaging study in patients undergoing intravascular stent placement for the treatment of coarctation of the aorta. We recommend IAI for all patients undergoing IS placement for treatment of CoA.

AB - Background: We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques. Methods and Results: Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005. About 27% (160/588) procedures were followed up by further IAI of their aorta (MRI/CT/repeat cardiac catheterization) after initial stent procedures. Abnormal imaging studies included: the presence of dissection or aneurysm formation, stent fracture, or the presence of reobstruction within the stent (instent restenosis or significant intimal build-up within the stent). Forty-one abnormal imaging studies were reported in the intermediate follow-up at median 12 months (0.5-92 months). Smaller postintervention of the aorta (CoA) diameter and an increased persistent systolic pressure gradient were associated with encountering abnormal follow-up imaging studies. Aortic wall abnormalities included dissections (n = 5) and aneurysm (n = 13). The risk of encountering aortic wall abnormalities increased with larger percent increase in CoA diameter poststent implant, increasing balloon/coarc ratio, and performing prestent angioplasty. Stent restenosis was observed in 5/6 parts encountering stent fracture and neointimal buildup (n = 16). Small CoA diameter poststent implant and increased poststent residual pressure gradient increased the likelihood of encountering instent restenosis at intermediate follow-up. Conclusions: Abnormalities were observed at intermediate follow-up following IS placement for treatment of native and recurrent coarctation of the aorta. Not exceeding a balloon:coarctation ratio of 3.5 and avoidance of prestent angioplasty decreased the likelihood of encountering an abnormal follow-up imaging study in patients undergoing intravascular stent placement for the treatment of coarctation of the aorta. We recommend IAI for all patients undergoing IS placement for treatment of CoA.

KW - Coarctation

KW - Intermediate complications

KW - Intravascular stent

UR - http://www.scopus.com/inward/record.url?scp=35348981904&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=35348981904&partnerID=8YFLogxK

U2 - 10.1002/ccd.21191

DO - 10.1002/ccd.21191

M3 - Article

C2 - 17896405

AN - SCOPUS:35348981904

SN - 1522-1946

VL - 70

SP - 569

EP - 577

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

IS - 4

ER -

Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this