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Endovascular treatment of aortic coarctation using covered balloon-expandable stents-a systematic review and

Fei He1, Zhongze Cao2, Chen Wang1

  • 1Department of Vascular Surgery, Huaihe Hospital, Henan University, Kaifong, Henan, China.

Frontiers in Cardiovascular Medicine
|November 1, 2024
PubMed

Insights

Covered balloon-expandable stents (CBSs) are safe and effective for treating coarctation of the aorta (CoA). This meta-analysis shows high success rates, significant hemodynamic improvements, and an acceptable complication profile for CBSs in CoA patients.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Coarctation of the aorta (CoA) is a congenital heart defect requiring effective treatment.
  • Balloon dilation and stenting are established treatments for CoA.
  • Evidence on the safety and efficacy of covered balloon-expandable stents (CBSs) in a large cohort is limited.

Purpose of the Study:

  • To evaluate the safety and efficacy of CBSs in treating coarctation of the aorta.
  • To assess procedural success rates, hemodynamic and anatomical benefits, complications, and mid-term outcomes of CBSs for CoA.
  • To provide a comprehensive meta-analysis of existing literature on CBSs for CoA.

Main Methods:

  • Systematic literature search of PubMed, Embase, and Cochrane Library databases.
  • Meta-analysis of 12 studies including 411 patients treated with CBSs for CoA.
  • Calculation of pooled procedural success rates, complication incidences, and changes in pressure gradients and blood pressure.

Main Results:

  • 100% procedural success rate for CBS implantation in CoA.
  • Significant reductions in trans-coarctation pressure gradients and systolic blood pressure observed.
  • Low pooled incidences of stent-related (2%), aortic (2%), and access site (3%) complications.

Conclusions:

  • Covered balloon-expandable stent implantation is a safe and effective treatment for coarctation of the aorta.
  • High procedural success rates and favorable hemodynamic outcomes are demonstrated.
  • An acceptable incidence of complications and low re-coarctation rates support the use of CBSs for CoA.
Abstract

Keywords:
aortic coarctationcongenital heart diseaseendovascularhypertensionstenting

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