Endovascular Stenting for Unsuccessful Angioplasty of the Aorta in Aortoarteritis

Journal Article · Mon Nov 15 04:00:00 EST 1999 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S002709900431· OSTI ID:21080252

Tyagi, Sanjay; Kaul, Upkar A; Arora, Ramesh ^[1]

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1. Department of Cardiology, G. B. Pant Hospital and Maulana Azad Medical College, New Delhi 110002 (India)

Purpose: The efficacy and safety of endovascular stent implantation to correct dissection or a suboptimal result after percutaneous transluminal angioplasty (PTA) was evaluated in patients suffering from aortic stenosis due to aortoarteritis. Methods: Twelve children and young adults [aged (mean {+-} SD) 18.2 {+-} 8.7 years] underwent stent implantation after PTA of the aorta, seven for obstructive dissection, four for ineffective balloon dilatation, and one for recurrent restenosis. Nine patients underwent implantation of self-expandable stents and three received balloon-expandable Palmaz stents. Results: Stent implantation could be successfully performed in all 12 patients. After stent implantation, the peak systolic pressure gradient decreased from 91 {+-} 33.5 mmHg to 12.4 {+-} 12.5 mmHg (p < 0.001). The diameter of the stenosed segment increased from 4.6 {+-} 0.8 mm to 11.1 {+-} 1.9 mm (p < 0.001). The dissection was completely covered in all seven patients with dissection. Except for epigastric pain with vomiting in one patient, there was no complication. On follow-up, over 12-57 months (mean 26.8 {+-} 10.8 months), 11 patients (91.6%) had marked improvement in their blood pressure. Patients with congestive heart failure and claudication also showed improvement. Repeat catheterization in five patients, between 6-30 months (mean 16.8 {+-} 9.1 months) after stent implantation, showed sustained improvement in four and a fusiform, long segment, intrastent restenosis after 30 months in one child. The stenosis was safely redilated. Conclusion: Endovascular aortic stent implantation is safe and provides good immediate relief in patients with unsatisfactory results after balloon angioplasty. Improvement is sustained in most patients on intermediate-term follow-up.

• OSTI ID: 21080252
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 6 Vol. 22; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AORTA
BLOOD PRESSURE
CHILDREN
HEART FAILURE
PAIN
PATIENTS
PRESSURE GRADIENTS
VOMITING