Percutaneous treatment of adult isthmic aortic coarctation: acute and long-term clinical and imaging outcome with a self-expandable uncovered nitinol stent

Circ Cardiovasc Interv. 2015 Jan;8(1). pii: e001799. doi: 0.1161/CIRCINTERVENTIONS.114.001799.

Percutaneous treatment of adult isthmic aortic coarctation: acute and long-term clinical and imaging outcome with a self-expandable uncovered nitinol stent.

Kische S1D'Ancona G2Stoeckicht Y1Ortak J1Elsässer A1Ince H1.

Comment: In this study Kische and colleagues assess the safety and efficacy of utilizing self-expandable uncovered nitinol stents to percutaneously treat adult ischemic coarctation of the aorta. The authors prospectively collected preoperative, perioperative, and long-term clinical and computed tomographic angiography data on 52 consecutive patients treated with the Sinus-XL stent. Percutaneous therapy was found to be acutely effective with postoperative peak trans-coarctation gradient being reduced and minimal aortic diameter increasing (both statistically significant). In long-term follow up, aortic computed tomography confirmed the absence of stent collapse and secondary migration and documented stability in aortic diameter. Thirty patients completely weaned-off antihypertensive medications and the number of medications per patient decreased. The authors conclude that adult coarctation of the aorta treatment by means of a self-expandable uncovered stent is safe and durable. The peculiar stent design maintains adequate localized radial strength over time with minimal trauma on the adjacent aortic wall and negligible device-related complications.