Analysis of 20 cases of primary coarctation of the aorta in children treated with transcatheter covered stent implantation
10.3760/cma.j.cn112140-20250413-00331
- VernacularTitle:经导管覆膜支架治疗儿童原发性主动脉缩窄20例分析
- Author:
Xiongyu LIAO
1
;
Zhiwei ZHANG
1
;
Yumei XIE
1
;
Shushui WANG
1
;
Lieqiang ZHONG
1
;
Junjie LI
1
Author Information
1. 广东省心血管病研究所 南方医科大学附属广东省人民医院（广东省医学科学院）心儿科，广州 510080
- Publication Type:Journal Article
- Keywords:
Aortic coarctation;
Stents;
Catheterization;
Child
- From:
Chinese Journal of Pediatrics
2025;63(10):1121-1125
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and early-to-mid-term efficacy of Cheatham-Platinum (CP) covered stent in treating primary coarctation of the aorta (COA) in children.Methods:?A retrospective self-controlled study was conducted on 20 pediatric patients with primary COA who underwent CP covered stent implantation at the Department of Pediatric Cardiology, Guangdong Provincial People′s Hospital, between January 2006 and December 2024. Clinical baseline characteristics, procedural details, and postoperative follow-up records were collected. Changes in aortic pressure gradients before and after the procedure, as well as the complication rates, were assessed. Comparisons between pre-and post-operative parameters were performed using paired Student′s t-tests and rank sum test. Results:Among the 20 patients, 14 were males and 6 were females, with the age of 12 (11, 13) years and the weight of 43 (36, 49) kg. All of the patients underwent successful implantation of CP-covered stents, with a technical success rate of 100%. The immediate peak gradient across the coarctation segment decreased significantly from 49 (33, 58) mmHg (1 mmHg=0.133 kPa) preoperatively to 3 (0, 5) mmHg postoperatively ( Z=3.92, P<0.001). The narrowest vessel diameter increased from (5.6±3.2) mm preoperatively to (16.9±5.4) mm postoperatively ( t=14.73, P<0.001). Following stent implantation, all patients exhibited a significant reduction in blood pressure, with left upper arm systolic blood pressure decreasing from(141±19) mmHg preoperatively to (122±11) mmHg postoperatively ( t=4.47, P<0.001). Immediate complications occurred in 3 cases: one pseudoaneurysm, one left subclavian artery occlusion, and one access site hematoma. During a follow-up period of 2 (1, 3) years, 16 patients maintained blood pressure within the normal range, while 4 had residual hypertension. Restenosis occurred in 3 patients: 1 patient underwent re-dilation at 24 months postoperatively; and the other 2 patients, who exhibited an upper-to-lower limb systolic blood pressure gradient <20 mmHg, did not require intervention at the time of reporting. All stents remained well-positioned. Follow-up CT angiography at 1 year in 8 patients demonstrated stent patency without evidence of fracture or aneurysm. Conclusion:CP-covered stent demonstrates high safety and favorable short-to-mid-term efficacy in treating primary COA in children.
