Percutaneous Balloon Coarctation Angioplasty: Long‐Term Results

Lababidi, Zuhdi

doi:10.1111/j.1540-8183.1992.tb00825.x

Cited by 35 publications

(7 citation statements)

References 44 publications

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“…Aneurysm formation at the dilation site has remained a long-term concern. Although early studies by Cooper et al (25) and Brandt et al (26) reported high incidence of aneurysm formation, most investigators have reported aneurysm formation incidence varying between 1.8% to 6% (12)(13)(14)27,28), which is consistent with our result (7.8%). No aneurysms were encountered by Koerselman et al (17) and Walhout et al (19).…”

Section: Discussionsupporting

confidence: 95%

Long-term outcome (up to 15 years) of balloon angioplasty of discrete native coarctation of the aorta in adolescents and adults

Fawzy

Awad

Hassan

et al. 2004

Journal of the American College of Cardiology

107

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Section: Discussionsupporting

confidence: 95%

Long-term outcome (up to 15 years) of balloon angioplasty of discrete native coarctation of the aorta in adolescents and adults

Fawzy

Awad

Hassan

et al. 2004

Journal of the American College of Cardiology

107

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“…We [15•,19•,37] and others [16] recommend repeat balloon dilatations in such cases, whereas still others [38] prefer surgical intervention.…”

Section: Recoarctationmentioning

confidence: 95%

Coarctation of the aorta

Rao¹

2005

Curr Cardiol Rep

123

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Coarctation of the aorta is an important, treatable cause of secondary hypertension. Its prevalence varies from 5% to 8% of all congenital heart defects. This condition is most often detected because of a murmur or hypertension found on routine examination. Delayed or absent femoral pulses and an arm/leg systolic blood pressure difference of 20 mm Hg or more in favor of the arms may be considered as evidence for aortic coarctation. The coarctation may be demonstrated on a suprasternal notch two-dimensional echocardiographic view along with increased Doppler flow velocities across the coarctation site. Cardiac catheterization reveals significant systolic pressure gradient (> 20 mm Hg) across the coarctation and angiography demonstrates the degree and type of aortic narrowing. Aortic obstruction may be relieved by surgery or by transcatheter techniques; the latter include balloon angioplasty and stent implantation. In the past, surgery has been used exclusively, but because of morbidity and complications associated with surgery, catheter techniques are increasingly used in the management of aortic coarctation. Balloon angioplasty in children and stents in adolescents and adults are becoming initial therapeutic options for management of coarctation. Studies evaluating long-term follow-up results of the interventional techniques are needed.

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“…There is scanty data on long-term followup after balloon angioplasty of native Coarctation [44,55,56]. Despite the problems of recoarctation and aneurysms, some requiring repeat intervention at intermediate-term follow-up, the long-term follow-up results (5 to 9 years) appear encouraging in that there was minimal incidence of late recoarctation and no late aneurysm formation.…”

Section: Long-term Follow-upmentioning

confidence: 99%

Coarctation of Aorta-Management Options and Decision Making

Doshi¹

2012

Pediat Therapeut

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Coarctation of the Aorta (CoA) is a congenital cardiac anomaly consisting of a constricted aortic segment with a prevalence of 5 to 8% of all Congenital Heart Defects (CHD). The classic CoA is located in the thoracic aorta distal to the origin of the left subclavian artery, at about the level of the ductal structure. Significant hypertension and/or congestive heart failure are indications of intervention. If hypertension (rather that heart failure) is the clinical problem, it is better to relieve the aortic obstruction promptly rather that attempting to "treat" hypertension with antihypertensive medications. Surgical relief of the aortic obstruction and catheter interventional techniques (balloon angioplasty and stents) are available alternatives. Since the introduction of surgical correction by Crafoord and Nylin and Gross and Hufnagel in early 1940s, surgical therapy has been the treatment of choice for aortic coarctation. Gruntzig's technique of balloon angioplasty was adopted by Singer and Sperling and their associates to enlarge coarcted aortic segments in post-surgical recoarctation and native coarctation, respectively in early 1980s. This is followed by the application of the technique by other cardiologists to treat native CoA. The procedure consists of inserting a balloon angioplasty catheter across the site of coarctation and inflating the balloon with diluted contrast material. Both immediate and followup results are reasonably good. Residual and recurrent obstructions following surgery and prior balloon angioplasty are also amenable for balloon angioplasty. Despite reasonably good short-term and long-term results of balloon angioplasty, some problems remain and include restenosis, probability of aortic rupture, formation of aneurysms and inability to effectively treat long-segment tubular narrowing. Because of these and other reasons, endovascular stenting of aortic coarctation has gained acceptance over the last decade. The balloon catheter, with the stent mounted on it, is advanced over a stiff guide wire and positioned across the coarctation segment and the balloon inflated, thus implanting the stent. Most cardiologists use stents in adolescents and adults and restrict their use in younger children because of issues related to growth. Stent therapy appears to be an attractive method for treatment of native or recurrent coarctation, aneurysm formation following prior surgical or balloon intervention and for long segment hypoplasia. Role of covered stents to manage aortic coarctation is limited and are used when the assessed risk for development of aneurysm or dissection is high. A comparison of all available treatment modalities was made and while it is difficult to make a definitive statement, the overall data seem to indicate that transcatheter methods may be better than surgery. Selection of the method of therapy is largely based on the age at presentation and anatomy of the coarcted segment and surrounding structures; surgery for infants and long segment coarctations, balloon angioplast...

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Percutaneous Balloon Coarctation Angioplasty: Long‐Term Results

Cited by 35 publications

References 44 publications

Long-term outcome (up to 15 years) of balloon angioplasty of discrete native coarctation of the aorta in adolescents and adults

Long-term outcome (up to 15 years) of balloon angioplasty of discrete native coarctation of the aorta in adolescents and adults

Coarctation of the aorta

Coarctation of Aorta-Management Options and Decision Making

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