ENDOVASCULAR TREATMENT OF AORTIC COARCTATION

Objectives: The aim of this study is to present our center’s experience with the endovascular treatment inaortic coarctation with a follow-up of 10 years. Background: Stent implantation has been evolved as an important therapeutic strategy for coarctation of the aorta. However, available data is frequently flawed by short follow up, retrospective data and disparity in the approach. Methods: Clinical data, imaging studies and angiographic outcomes of 24 patients treated for CoA were reviewed between january 2007 to december2018. We included native diagnosed aortic coarctation (NCO) and recurrent coarctation. Results: There were 57% male patients and 43% female with a mean age of 26+/- 11 years. 90% of patients had NCO and 10% had re-coarctation after surgical repair in childhood (21+/- 4years after initial repair). Endovascular treatment was performed using BMS (PalmazGenesis peripheral stent, Cordis) in 71% of cases. Covered stent (mounted covered CP stent; Numed) was placed in 2 patients. One patient was treated by balloon angioplasty. Acute procedural success had reached 92% in our series with a technical failure in 2 cases. Mean lesion length and diameter were respectively 15,3+/-11,9 mm and 7,2+/- 2,7mm. Mean systolic pressure gradient decreased from 51,4 +/- 20,4 mm Hg to 7,7±10 mmHg (P < 0,05). After a mean follow-up of 60 +/- 38 months, the blood pressure profile was evaluated. the CT scan showed a local aortic wallanevrysms in 1 patient (4.1%). Surgical intervention was needed in 2 patients forrecoarctationand aortic valve replacement. Conclusion: Percutaneous aortic coarctation treatment is effective with an acceptable safety and a good long-termoutcome. Therefore, patients require regular clinical and radiological monitoring tobalance blood pressure, look for local aortic wall complications and assess associated lesions such as aortic bicuspid valve and ascending aorta dimension.