Endovascular techniques in adult aortic coarctation: the use of stents for native and recurrent coarctation repair.

Abstract

To report initial experiences with stent implantation in the treatment of native and recurrent aortic coarctation in adults. Two adult patients were diagnosed with aortic coarctation: in one, the native aorta was involved, and in the other, the stenosis involved a prior coarctation repair. Both patients were offered and selected angioplasty with possible stent implantation as an alternative to surgery. In the patient with recurrent narrowing, thrombolysis and balloon dilation preceded the successful deployment of three Palmaz stents along the grafted segment. In the case of native disease, one Palmaz stent was implanted primarily at the site of a critical, focal stenosis. No complications were encountered, and recovery was uneventful. Follow-up at 12 and 6 months, respectively, showed sustained clinical improvement with resolution of symptoms and excellent hemodynamic values. The positive outcome in these early cases supports further evaluation of the efficacy of adjunctive or primary stenting for treatment of native or recurrent aortic coarctation in adults.