Initial experience using the NuMED Cheatham Platinum (CP) stent for interventional treatment of coarctation of the aorta in children and adolescents

Abstract

We report the immediate results in a group of selected patients with native or recurrent coarctation of the aorta who underwent endovascular stent implantation using the newly designed Cheatham-Platinum (CP)-stent. The balloon-expandable stents were implanted in 6 patients (mean age 12.7 years) with coarctation of the aorta (5 native, 1 recurrent). The maximal systolic peak pressure gradient was decreased from 49 to 3 mmHg (p <0.001). There was a 350% increase in the mean diameter at the original coarctation site (3.8 to 13.8 mm, p <0.01). Although the maximal diameter varied from 8 to 18 mm, there was only a minor reduction in the length of the CP-stents used (max. 11%). The dilatation was successful in all patients and there were no complications during balloon dilatation or stent implantation. All patients were hypertensive prior to stent implantation, with three of them requiring antihypertensive drug therapy. In 2 patients only a moderate dilatation diameter was chosen initially due to the extremely small coarctation site (1 mm) and repeat dilatation after 12 months was performed in order to obtain a maximal aortic diameter. At a mean of 18 months of follow-up, 5 of 6 patients are normotensive. There is no recurrence of coarctation, aortic dissection or aneurysm formation and no stent displacement. These findings suggest that the implantation of CP-stents for coarctation of the aortamay cover a wide spectrum of aortic diameters and consequently hereby offer an effective alternative approach to surgery or ballon dilatation alone even in infancy and childhood. The potential for redilatation of CP-stents in a wide range of diameters without significant shortening adds to the benefit of this device in growing children.

Percutaneous approach to a tight post-isthmic aortic coarctation: a case report and literature review

“…The most serious complication is the aorta rupture which can be fatal, but it is rare (<two%), other complications such as the aneurysmatic dilatation, re-stenosis and stent failure can be controlled during and after the procedure [5]. The Haas group has collected the first evidences of percutaneous stents correction of aortic coarctation in infants and adolescents using Cheatham-platinum -CP stent, thought on a small sample [6]. On 6 patients with aortic coarctation (mean age 12.7 years old; five native, one re-coarctation) treated with percutaneous stenting it was seen a reduction in the systolic gradient at the maximum pick from 49 mmHg to three mmHg (p<0,001) with an increment of 350% of the coarted site diameter (p<0.001).…”

Cheatham-Platinum stent implantation for pulmonary artery stenosis in children and adolescents: immediate and mid-term outcome

“…Expanded diameters suggest that CP stent can be further redilated many years later. [9] Hence CP stent in growing children is capable of being redilated CP stents for pulmonary artery stenosis…”

“…[5] Over the past 10 years, NuMED CheathamPlatinum (CP) stent, which is specifi cally designed to treat vascular obstructions associated with CHD, has increasingly attracted the interest of interventional cardiologists. [6][7][8][9] However, the application of this new stent in the pediatric population is relatively uncommon, Original article especially in those with pulmonary artery stenosis. In addition, previous follow-up of CP stents for pulmonary artery stenosis was limited, including a 12-month (range, 1-30 months) follow-up reported by Ewert et al [8] Furthermore, CP stent implantation for pulmonary artery stenosis has not been reported in China so far.…”

New Approach for Hybrid Stenting of the Aortic Arch in Low Weight Children

“…A more radical method is stenting of the aortic arch and isthmus via implantation of a stent that can be expanded as the body grows [9]. However, it is not possible to perform such a percutaneous procedure in infants and young children due to their small vessels and the large delivery catheters needed for the procedure [10,11]. To overcome these difficulties, a hybrid technique for stent implantation via access through the ascending aorta has been introduced [9,12].…”