Key result
Covered stent implantation for aortic coarctation was associated with a lower incidence of related-procedure adverse events compared to bare stents (8.3% vs. 21.1%, P=0.035).
Why the study?
Does covered stent implantation reduce procedure-related adverse events and complications compared to bare stent implantation in patients with aortic coarctation?
Cohort (n=143)
No
Does covered stent implantation reduce procedure-related adverse events and complications compared to bare stent implantation in patients with aortic coarctation?
Covered stent implantation for aortic coarctation is associated with significantly lower rates of procedure-related adverse events and aortic wall complications compared to bare stents, despite being used for more complex lesions.
Answers are grounded in this paper and cite their sources.
May support covered stents to lower procedure adverse events in aortic coarctation; leaves open need for randomized confirmation.
BACKGROUND: Bare stents has become the first line therapy for aortic coarctation. Covered stents has been reported more recently in clinical practice. OBJECTIVES: The present study, reports comparatively 15-year experience of bare and covered stent implantation for aortic coarctation in a single tertiary referral center. METHODS: From 1997 to 2011, 143 patients with native or postoperative aortic coarctation were treated at our institution. Seventy-one subjects (median age 17 years (range from 4 to 70 years) underwent bare stent implantation (Group 1) while 72 patients (median age of 17.5 years (range from 6 to 68 years) underwent covered stent implantation (Group 2). RESULTS: Success rate in the whole group was 95%. More complex and tighter coarctations were treated using covered stents. Incidence of related-procedure adverse events was higher in Group 1 than in group 2 (21.1% vs. 8.3% P = 0.035). Aortic wall complications occurred in 7% of patients in Group 1 (one death) and 0% in Group 2 (P = 0.028). Subjects in Group 1 had a longer follow-up (median 85 vs. 35 months; P < 0.001). Independent predictors associated with reintervention included the presence of complex lesions (HR: 2.70; CI: 1.15-6.32), balloon diameter used <14 mm (HR: 3.76; CI: 1.48-9.55), and immediate residual gradient >10 mm Hg (HR: 4.30; CI: 1.96-9.47). CONCLUSIONS: Both bare and covered stent implantation for aortic coarctation is a safe and efficacious treatment. By using covered stent implantation the spectrum of patients treated has increased with lower rates of acute and late complications.
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Butera et al. (2014) conducted a cohort in Aortic coarctation (n=143). Covered stent implantation vs. Bare stent implantation was evaluated on related-procedure adverse events (p=0.035). Covered stent implantation for aortic coarctation was associated with a lower incidence of related-procedure adverse events compared to bare stents (8.3% vs. 21.1%, P=0.035).
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