BeGraft Aortic Stent for Treatment of Aortic Coarctation: Acute and Intermediate Results

Covered stent implantation is an effective treatment for coarctation of the aorta (CoA) and can reduce aortic wall injury; however, stent-related complications, including recoil, restenosis, infolding, and access site injury, are of concern.

Report our institutional experience using the BeGraft Aortic covered stent for native and recurrent CoA.

Retrospective review of consecutive patients treated for CoA from January 2017 to April 2025 [IRB RMC 389-22].

Eighty-five patients [61 male], median age 14.1 years, median weight 50 kg, underwent implantation of 92 BeGraft Aortic stents, 71 (84%) through a 9 Fr sheath. CoA diameter increased by 170% (IQR 150%-270%) and pressure gradient decreased by 16 mmHg (IQR 10-23 mmHg) to a median of 4 mmHg (IQR 0-6 mmHg). Final stent-to-balloon diameter ratio was 0.94 ± 0.05 (5.6% recoil, IQR 2.8%-9.4%). During median follow-up of 2.7 years (IQR 1.0-4.3 years, max 7.3 years), 38 patients underwent re-imaging (CT, angiography), which demonstrated two new aneurysms. Eight aneurysms present prior to BeGraft aortic implantation completely resolved, and one patient had an asymptomatic femoral artery occlusion. Of the 24 patients who underwent additional catheterizations, 19 had re-interventions, 13 balloon dilations, and 6 stent implantations: 10 restenosis, 7 somatic growth, and 2 aneurysms.

In this single-center experience, BeGraft Aortic covered stents were associated with favorable technical results, including minimal stent recoil and low rates of reintervention for restenosis or aneurysm formation. The low-profile delivery system affords treatment of CoA for smaller children with low risk for vascular damage.