Percutaneous balloon catheter angioplasty of coarctation of the abdominal aorta: Report of two cases

Schechter, Charles; Angelini, Paolo; Treistman, Bernardo

doi:10.1002/ccd.1810110408

Cited by 17 publications

(6 citation statements)

References 11 publications

(3 reference statements)

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“…Six patients also had stenoses of 8 renal arteries, and 3 had splanchnic arterial obstructions. '5 bReferences 2,[6][7][8]11,12,13,15,16,[19][20][21][31][32][33][34] 'References 2,5,11,[13][14][15][16]19,[22][23][24][25][26]35,36 dReferences [6][7][8]11,13,15,19…”

Section: Congenitalmentioning

confidence: 99%

“…The use of stent technology has generated increasing interest in the management of aortic coarctation. [22][23][24][25]27,68,70 Extensive data exist in patients treated for isthmic coarctation27,64,68; however, limited data are available on the efficacy and durability of stent grafting for the MAS. The complex anatomic configuration and variable stenoses of the mesenteric and renal arteries in relation to the abdominal aortic segment afflicted by the MAS1-35 7,8 Ii 13 1 16 19,48 renders endovascular therapy a challenging endeavor.…”

Section: Endovascular Therapymentioning

confidence: 99%

“…A high propensity for Pers Vasc Surg Endovasc Ther 17:187-206, 2005. both visceral and renal artery stenoses is attached and aortic rupture that best portray the clinical progression of MAS if left unrepaired,'13,6 8,11,13,19 most of untreated patients succumbing before the age of 40.3 11 15,20,21 The treatment is predominantly surgical, entailing reconstruction of the aortic stenosis, with (aortoaortic) bypass grafting or patch aortoplasty, whereas visceral reconstruction is performed with bypass grafting of the narrowed renal and visceral arteries.1-3 [5][6][7][8]11,[13][14][15][16]19 Endovascular treatment, primarily in the form of balloon angioplasty, has also been used with variable success for treatment of MAS over the past two decades. 16,[22][23][24][25][26][27][28][29][30] In this comprehensive review, we offer a detailed account of the etiologies and clinical presentation of MAS, discuss the evaluation and natural history of the disease, and also provide a layout of the open surgical and endovascular treatment options in light of their associated shortand long-term clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Middle Aortic Syndrome: From Presentation to Contemporary Open Surgical and Endovascular Treatment

Delis

Gloviczki²

2005

Perspectives in Vascular Surgery and Endovascular Therapy

153

188

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Middle aortic syndrome (MAS) is a clinical condition generated by segmental narrowing of the abdominal or distal descending thoracic aorta. MAS may be acquired, caused by Takayasu's or temporal arteritis (giant cell arteritides), neurofibromatosis, fibromuscular dysplasia, retroperitoneal fibrosis, mucopolysaccharidosis, and the Williams syndrome, or congenital, ascribed to a developmental anomaly in the fusion and maturation of the paired embryonic dorsal aortas. Segmental aortic stenosis may be located at the suprarenal, inter-renal or infrarenal aorta, with a high propensity for concomitant stenoses in both the renal (63%) and visceral (33%) arteries. Hypertension proximal to the aortic stenosis, and relative hypotension distal to it, are characteristic findings in MAS. Typical manifestations include headache, early fatigue on exertion, and bilateral lower-limb claudication. The severity of hypertension is the primary indication for intervention and the factor determining procedural timing. As a great proportion of patients with MAS are children or teenagers, the clinical benefits of early surgical intervention to reverse refractory hypertension have to be weighed against the repercussions pertaining to the insult of surgery on the developing aorta. Open surgery is the primary treatment of tubular aortic narrowing (MAS) associated with renovascular hypertension and visceral artery stenosis. This entails aortoaortic bypass of the diseased segment or, less often, patch aortoplasty and usually bypass grafting of the stenosed renal and visceral arteries performed with autologous conduits, particularly in the youngest of patients. Endovascular therapy may provide a sound minimally invasive treatment in MAS caused by discrete aortic stenoses that do not encompass the mesenteric and renal arteries. Hypertension is thus improved or cured in more than 70% of patients. Prognosis after uncompromised surgical reconstruction is rewarding in the mid and long term in patients with congenital aortic coarctation but deteriorates in patients with aortoarteritis and recurrent inflammatory activity.

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Section: Congenitalmentioning

confidence: 99%

Section: Endovascular Therapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Middle Aortic Syndrome: From Presentation to Contemporary Open Surgical and Endovascular Treatment

Delis

Gloviczki²

2005

Perspectives in Vascular Surgery and Endovascular Therapy

153

188

View full text Add to dashboard Cite

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“…Endovascular therapy has been used for MAS with some short-term success. Schechter et al 17 reported on 2 patients who underwent balloon angioplasty with good immediate-and short-term results. Delayed aneurysm formation is reported to occur in 5% to 20% of cases after angioplasty.…”

Section: Discussionmentioning

confidence: 97%

Long-Term Complications in Two Patients After Aortoaortic Bypass for Midaortic Syndrome

Bhende

Smead

et al. 2013

Annals of Vascular Surgery

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“…A detailed account of balloon angioplasty and stenting in patients with aortic coarctation of the abdominal aorta (middle aortic syndrome) has been previously reported. 17 Schechter and colleagues, 86 Singer and colleagues, 87 Adwani and colleagues, 88 and Fava 89 performed balloon angioplasty for coarctation of the abdominal aorta with or without aorto-arteritis with promising initial success; yet, the long-term outcome was substantially impaired because of a substantial grade of vessel recoil or aneurysm formation caused by multiple tears and cracks in the intima or splits of various grades in the media. 90 Stent technology and its advancement has rekindled interest in the treatment of aortic coarctation; however, only limited data are available on the effect their deployment may have in patients with middle aortic syndrome, particularly in patients with NF-1.…”

Section: Aortic Coarctation/aneurysmal Diseasementioning

confidence: 99%

Neurofibromatosis Type 1: From Presentation and Diagnosis to Vascular and Endovascular Therapy

Delis

Gloviczki²

2006

Perspectives in Vascular Surgery and Endovascular Therapy

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Neurofibromatosis type 1, also called von Recklinghausen's disease, is an autosomal dominant disorder linked to chromosome 17, characterized by growth impairment of the neural crest cells (ectoderm) manifested by multiple neural tumors, cutaneous pigmentations, and Lisch nodules. Disease phenotype develops with time, making its penetrance almost complete by 5 years of age. Compression of the gastro-intestinal, urinary, or pulmonary tracts by visceral neurofibromas may generate serious complications. Neurofibromatosis type 1 is remarkable for its association with occlusive (stenoses) or aneurysmal arterial disease affecting predominantly the renal arteries and less often the abdominal aorta (middle aortic syndrome), and mesenteric and peripheral arteries. Appraisal of existing literature reveals that timely vascular intervention by way of conventional surgery and/or endovascular therapy may provide patients with effective and durable treatment. The far greater propensity for malignant connective/soft-tissue neoplasms and vascular disease in neurofibromatosis type 1, amid potential complications from the gastro-intestinal, urinary, and pulmonary tracts, leads to a significantly increased morbidity and decreased life expectancy. Neurofibromatosis type 1, from presentation and diagnosis to its treatment, is reviewed, with emphasis on vascular disease and its management with open vascular surgery and endovascular therapy.

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Percutaneous balloon catheter angioplasty of coarctation of the abdominal aorta: Report of two cases

Abstract: Two patients with coarctation of the abdominal aorta are reported. They both underwent successful transluminal balloon angioplasty. The immediate and short-term results have been excellent. This method and its role in the treatment of coarctation of the abdominal aorta are discussed.

Cited by 17 publications

References 11 publications

Middle Aortic Syndrome: From Presentation to Contemporary Open Surgical and Endovascular Treatment

Middle Aortic Syndrome: From Presentation to Contemporary Open Surgical and Endovascular Treatment

Long-Term Complications in Two Patients After Aortoaortic Bypass for Midaortic Syndrome

Neurofibromatosis Type 1: From Presentation and Diagnosis to Vascular and Endovascular Therapy

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