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Initial experience with a novel ePTFE-covered balloon expandable stent in patients with near-atretic or severe aortic coarctation and small femoral arterial access

Published online by Cambridge University Press:  11 November 2020

Asim Al Balushi ,
Emma Pascall ,
Matthew I. Jones ,
Shakeel Qureshi Open the ORCID record for Shakeel Qureshi [Opens in a new window]  and
Gianfranco Butera Open the ORCID record for Gianfranco Butera [Opens in a new window]
Asim Al Balushi
Affiliation:
Department of Congenital Cardiology, Evelina London Children’s Hospital, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
Emma Pascall
Affiliation:
Department of Congenital Cardiology, Evelina London Children’s Hospital, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
Matthew I. Jones
Affiliation:
Department of Congenital Cardiology, Evelina London Children’s Hospital, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
Shakeel Qureshi
Affiliation:
Department of Congenital Cardiology, Evelina London Children’s Hospital, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
Gianfranco Butera*
Affiliation:
Department of Congenital Cardiology, Evelina London Children’s Hospital, Guy’s & St Thomas’ NHS Foundation Trust, London, UK School of Biomedical Engineering and Imaging Sciences, Kings College, London, UK
*
Author for correspondence: Gianfranco Butera, Department of Paediatric Cardiology, Evelina London Children’s Hospital, Guy’s & St Thomas’ NHS Foundation Trust, Westminster, Bridge Rd, St Thomas’ Hospital, London SE1 7EH, UK. Tel: +44 7917172581. E-mail: gianfrancobutera@libero.it
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Abstract

Objectives:

We report our experience of using the Bentley BeGraft Aortic stent in patients with severe or near-atretic aortic coarctation and small femoral arterial access.

Background:

Use of covered stent is recommended in some settings such as aortic coarctation with associated aneurysm, Turner syndrome, and coarctation with aortic atresia. However, currently available covered stents need larger sheaths that may limit their use in children and patients with smaller arterial access. Newer stents may overcome this limitation.

Methods:

Single-centre retrospective study of patients with severe or near-atretic aortic coarctation and small femoral arterial access.

Results:

Between July and October, 2019, five patients (median age 15 years) with near-atretic or severe coarctation were treated with a Bentley BeGraft Aortic stent. Long sheaths between 9 and 11 Fr were used to implant stents, which were dilated up to 12–16 mm. None of the patients had residual coarctation (gradient >20 mm of mercury) after stenting. None of the patients developed acute vascular injuries or local access related complications at the end of the procedure or during follow-up (range 6–10 months).

Conclusions:

Bentley BeGraft aortic stents are important to consider in patients with severe coarctation and provided acute procedural success in patients with small femoral arterial access and widen the applicability in this patient population.

Keywords

congenital heart diseasepercutaneousaortic coarctationcovered stent
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 2 , February 2021 , pp. 224 - 228
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Asim Al Balushi and Emma Pascall equally contributed to the paper.

References

Forbes, TJ, Moore, P, Pedra, CA, et al. Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta. Catheter Cardiovasc Interv 2007; 70: 569–577.CrossRefGoogle ScholarPubMed
Taggart, NW, Minahan, M, Cabalka, AK, et al. Immediate outcomes of covered stent placement for treatment or prevention of aortic wall injury associated with coarctation of the aorta (COAST II). JACC Cardiovasc Interv 2016; 9: 484–493.CrossRefGoogle Scholar
Forbes, TJ, Kim, DW, Du, W, et al. Comparison of surgical, stent, and balloon angioplasty treatment of native coarctation of the aorta: an observational study by the CCISC (Congenital Cardiovascular Interventional Study Consortium). J Am Coll Cardiol 2011; 58: 2664–2674.CrossRefGoogle Scholar
Sohrabi, B, Jamshidi, P, Yaghoubi, A, et al. Comparison between covered and bare Cheatham-Platinum stents for endovascular treatment of patients with native post-ductal aortic coarctation: immediate and intermediate-term results. JACC Cardiovasc Interv 2014; 7: 416–423.CrossRefGoogle ScholarPubMed
Meadows, J, Minahan, M, McElhinney, DB, McEnaney, K, Ringel, R, Investigators* C . Intermediate outcomes in the prospective, multicenter Coarctation of the Aorta Stent Trial (COAST). Circulation 2015; 131: 1656–1664.CrossRefGoogle Scholar
Qureshi, SA, Zubrzycka, M, Brzezinska-Rajszys, G, Kosciesza, A, Ksiazyk, J. Use of covered Cheatham-Platinum stents in aortic coarctation and recoarctation. Cardiol Young 2004; 14: 50–54.CrossRefGoogle ScholarPubMed
Momenah, TS, Khan, MA, Qureshi, S, Hijazi, ZM. Acquired aortic atresia: catheter therapy using covered stents. Catheter Cardiovasc Interv 2015; 86: 1063–1067.CrossRefGoogle ScholarPubMed
Hussein, H, Walsh, K. First in man use of the Advanta trademark V12 ePTFE-coated stent in aortic coarctation. Catheter Cardiovasc Interv 2009; 74: 101–102.CrossRefGoogle ScholarPubMed
Nordmeyer, J, Kramer, P, Berger, F, Schubert, S. Successful exclusion of an aortic aneurysm with a novel PTFE-tube covered cobalt-chromium stent in a pediatric patient with native coarctation of the aorta. Catheter Cardiovasc Interv 2018; 92: 930–934.CrossRefGoogle Scholar
Bruckheimer, E, Birk, E, Santiago, R, Dagan, T, Esteves, C, Pedra, CA. Coarctation of the aorta treated with the Advanta V12 large diameter stent: acute results. Catheter Cardiovasc Interv 2010; 75: 402–406.Google ScholarPubMed
Hayes, N, Podnar, T, Qureshi, S. Collapse of the Advanta V12 Large Diameter covered stent following implantation for aortic coarctation. Catheter Cardiovasc Interv 2014; 83: 109–114.CrossRefGoogle ScholarPubMed
Wan, AW, Lee, KJ, Benson, LN. Infolding of covered stents used for aortic coarctation: report of two cases. Catheter Cardiovasc Interv 2014; 83: 104–108.CrossRefGoogle ScholarPubMed
Goreczny, S, Dryzek, P, Moszura, T, Kuhne, T, Berger, F, Schubert, S. 3D image fusion for live guidance of stent implantation in aortic coarctation – magnetic resonance imaging and computed tomography image overlay enhances interventional technique. Postepy Kardiol Interwencyjnej 2017; 13: 269–272.Google ScholarPubMed
Wiegerinck, EM, Marquering, HA, Oldenburger, NY, et al. Imaging for approach selection of TAVI: assessment of the aorto-iliac tract diameter by computed tomography-angiography versus projection angiography. Int J Cardiovasc Imaging 2014; 30: 399–405.CrossRefGoogle ScholarPubMed