If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Expandable Stents May Help Avoid Surgery in Young Children With Coarctation of the Aorta: Presented at SCAI By Carole VanSickle Ellis LAS VEGAS -- May 14, 2009 -- Intravascular stent implantation to treat coarctation in children aged 5 to 12 years appears feasible with minimal dangers of technical or aortic complications for the procedure, researchers stated here at the 32nd Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions (SCAI). The results of the study also showed that the procedure could be a far better solution than invasive open-heart surgery for young children. Thomas Forbes, MD, Wayne State University, and Cardiac Catheterization Laboratory, Children's Hospital of Michigan, Detroit, Michigan, presented the results here on May 7. Previously, it was accepted that expandable stent implantation as a treatment for coarctation was a good option for adolescents and adults, but this age group had not been comprehensively studied or analysed. The research group took data from 41 medical centres on stents implanted in children aged 5 to 12 years from 2001 to 2008. There were a total of 285 intravascular stent implantations in these institutions over this time period and 82 of them were for children aged 5 to 12 years (median age, 10 years). To measure improvement immediately following the implantation and then again 1.5 years later, data on the average diameter of the aorta at the coarctation site was collected using imaging studies of the aorta, as well as the systolic gradient and the resting blood pressure. Complications were also documented through patient medical records and medication history. Complete follow-up data, through 18 months later, was available for 37 of the 82 patients on file. The study found that there was significant immediate and longer-term improvement. The average diameter of the aorta at the site of coarctation increased from 6.2 to 11.6 mm after the implantation. The procedure immediately reduced the average blood pressure difference between the upper and lower body from 31.6 to 2.7 mm Hg, and 1.5 years later the patients still in the study had an average systolic gradient of 3 mm Hg. Nine of those patients were taking blood pressure medication by this time. In addition, 4 patients showed mild reobstruction of the stented area and 1 showed moderate reobstruction. Two patients had limited tears in the aortic wall, but did not require any additional surgery. There was 1 broken stent, which was replaced, and there were 4 re-expansion surgeries, all of which were successful and without complication. From these results, the researchers believe that stent placement for coarctation is an effective, feasible treatment option for children in this age group. However, the authors acknowledged that more long-term follow-up data is needed before the treatment can become routine. [Presentation title: Intermediate Follow-Up of Native and Recurrent Coarctation Stent in Children 5-12 Years of Age. Abstract 460]
|
