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Endovascular stenting for unsuccessful angioplasty of the aorta in aortoarteritis

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Abstract

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.

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Authors and Affiliations

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

    Sanjay Tyagi M.D., Upkar A. Kaul & Ramesh Arora

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  1. Sanjay Tyagi M.D.
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  2. Upkar A. Kaul
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  3. Ramesh Arora
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Tyagi, S., Kaul, U.A. & Arora, R. Endovascular stenting for unsuccessful angioplasty of the aorta in aortoarteritis. Cardiovasc Intervent Radiol 22, 452–456 (1999). https://doi.org/10.1007/s002709900431

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