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Experience with the Atrium Advanta covered stent for aortic obstruction
Naoki Ohno1, Rajiv Chaturvedi, Kyong-Jin Lee
1Department of Pediatrics, Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
The Advanta V12 stent effectively treats coarctation of the aorta (CoA), showing early safety and positive clinical outcomes. Further research is needed to confirm long-term efficacy of this stent implantation.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Coarctation of the aorta (CoA) is a congenital heart defect requiring effective management.
- The Advanta V12™ covered stent is a potential therapeutic option for CoA.
Purpose of the Study:
- To evaluate the efficacy, safety, and clinical outcomes of the Advanta V12™ covered stent in managing coarctation of the aorta.
Main Methods:
- Retrospective review of 17 patients who underwent Advanta V12™ stent implantation for CoA.
- Assessment included angiographic imaging, clinical data, chest roentgenograms, radiation exposure, and complications.
- Clinical outcomes were evaluated at admission, discharge, and latest follow-up (median 242 days).
Main Results:
- Significant improvement in aortic diameter (6.6 to 11.5 mm) and reduction in peak pressure gradient (23.1 to 0.8 mmHg) were observed (P<0.0001).
- No symptomatic complications occurred; blood pressure gradients normalized post-implantation (P<0.0001).
- While 18% required reintervention and 33% initially needed antihypertensives, long-term outcomes were stable.
Conclusions:
- Advanta V12™ stent implantation demonstrates early safety and effectiveness in treating coarctation of the aorta.
- The procedure led to significant hemodynamic improvements and was well-tolerated in the short term.
- Longer-term efficacy of the Advanta V12™ stent for CoA requires further investigation.
Introduction:
We sought to assess the efficacy, safety and clinical outcomes of the Advanta V12™ covered stent in management of coarctation of the aorta (CoA).
Materials And Methods:
Stent functionality was assessed by review of angiographic imaging, clinical data at admission, discharge and at the last clinic visit, stent configuration on chest roentgenogram, radiation exposure, and complications.
Results:
Between October 2009 and February 2012, 17 patients underwent stent implantation. There were 9-12, 2-14, and 6-16 mm diameter stents deployed. Balloon angioplasty after implantation was required in 2 patients. Mean percent recoil in the middle of the stent for the 12, 14, and 16 mm implants was 14%, 24%, and 24%, respectively. There was improvement in CoA diameter from 6.6 ± 3.2 to 11.5 ± 1.7 mm (P<0.0001) and a reduction in the peak pressure gradient from 23.1 ± 10.1 to 0.8 ± 3.3 mmHg (P<0.0001). No patient had a symptomatic complication. Left arm cuff blood pressure fell 24 hours after implantation and left arm to leg blood pressure gradient fell to <20 mmHg in all (P<0.0001). Follow-up was a median 242 days and at the last clinic visit there were no statistically different findings from discharge. Five children (33%) required antihypertensive medications but 3 were off medication at latest follow-up. Three patients (18%) required reintervention.
Conclusion:
The implantation of the Advanta™ V12 stent for the treatment of CoA is safe and effective in the early term. However, further study is required to determine longer-term stent efficacy.
