Short and Long-term Consequences/results of Covered Stents in Children for the Management of Complex Coarctation of the Aorta

Abstract

Background: The use of covered stents in cases of complex coarctation of the Aorta is now increasing. However, its long-term benefits for children, adolescents and young adults remain unclear. We assessed the long-term results of covered stents in children with complex coarctation of the Aorta. Methods: Forty-seven children with complex coarctation of the Aorta treated with covered stents were retrospectively assessed. The patients were followed up for 6 to 12 months to evaluate the long-term outcome. Results: The most common indications for using covered stent were long segment coarctation of the Aorta plus hypoplasia of the aortic arch (23.4%) followed by coarctation of the Aorta with PDA (23.4%) and interrupted aortic arch (19.1%). A single stent was used in 87.2%, two and three covered stents were used in 10.6% and 2.1%, respectively. During follow-up, short-term procedural complications were detected in 25.5% included isolated residual coarctation of the Aorta in 25.0%, followed by residual coarctation of the Aorta plus closure of the left subclavian artery in 16.6%. Short-term complications were femoral artery dissection (8.3%), femoral artery thrombosis (8.3%), stent dislocation and closure of left subclavian artery (8.3%), residual COA and closure of left subclavian artery (16.6%), residual COA (25%), endoleak (8.3%), endoleak and pseudoaneurysm (8.3%), endoteliaztion (8.3%) and retroperitoneal hematoma (8.3%). In long-term following-up, 10.6% showed significant complications including endoleak, residual hypertension, and residual coarctation. Overall, 25.6% underwent re-dilation successfully. Conclusion: The covered stent can be used as an effective and uncomplicated treatment in children with complex coarctation of the Aorta.