Self-Expanding Versus Balloon-Expandable Stents in Patients With Isthmic Coarctation of the Aorta

Canadian Cardiovascular Society 2022 Guidelines for Cardiovascular Interventions in Adults With Congenital Heart Disease

“…The type of stent used will depend on the operator's preference and technical specifications. 134 If the CoA site is long and tubular or if there is concomitant diffuse arch hypoplasia, a surgical approach is usually favoured because of concerns about perfusion and injury to spinal arteries. Surgical repair can be done by end-toend anastomosis (most frequent), graft interposition, Dacron patch repair, subclavian flap repair or, rarely, ascending aorta to descending aorta bypass with a conduit.…”

Stent Implantation and Balloon Angioplasty for Native and Recurrent Coarctation of the Aorta

“…23) A self-expandable stent was shown to be associated with a lower incidence of major adverse events compared with a balloon-expandable stent in patients with suitable anatomy. 24) However, although a wide variety of stent types was included in the present study, it was impossible to identify each device per individual study and conduct a subgroup analysis. Furthermore, it is suggested that the choice of stent type may be affected by several factors, such as treatment of NaCo or ReCo, patients' age, and morphology of CoA.…”

Late open conversion after endovascular treatment for the coarctation of aorta in adult due to restenosis with thrombus

“…The search terms included "adult coarctation of aorta" or "adult aortic coarctation" or "adult CoA" and "endovascular" or "TEVAR" or "transcatheter." Our search identified 27 eligible studies from 528 records, including 2 randomized controlled studies 11,21 and 25 observational studies, 3,7,15,17,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] with 2022 patients enrolled. The patient characteristics and outcomes are summarized in the Table.…”

“…23 Some subsequent studies reported that self-expandable devices had a low AWI rate, which was attributed to stent conformability to the aortic anatomy. 34 In contrast, it has been reported that balloon-expandable stents with a high radial force are necessary to treat severe stenosis and recurrent CoA. Especially in the case of recurrent CoA, fibrotic scar tissue can lead to increased stiffness of the stenosis and inadequate dilation.…”