alexa Stenting complex aortic arch obstructions.
Pediatrics

Pediatrics

Pediatrics & Therapeutics

Author(s): Holzer RJ, Chisolm JL, Hill SL, Cheatham JP

Abstract Share this page

Abstract OBJECTIVE: To present our institutional experience of endovascular stent therapy in patients with complex aortic arch lesions. BACKGROUND: The management of aortic arch obstructions is complex and many physicians are either reluctant to treat mild-moderate aortic arch lesions associated with systemic hypertension or instead refer to high-risk surgical alternatives. Reported data on transcatheter stent therapy of complex aortic arch lesions are scarce. METHODS: Between October 2002 and November 2006, 40patients (pts) had complex aortic arch lesions treated with stent implantation in 42 procedures (proc). Aortic arch hypoplasia was present in 30/42 proc (71.4\%). The median age was 10 year (16 days - 37 years). In 40/42 proc (95.2\%) patients had previous transcatheter or surgical aortic arch interventions. RESULTS: Procedural success in achieving a peak systolic gradient reduction to or=90\% of the "normal" adjacent aortic arch was achieved in 38/42 proc (90.5\%). The diameter of the arch obstruction increased from a median of 7.55 mm to a median of 14 mm (P < 0.0001) and the peak systolic gradient was reduced from a median of 23 mm Hg to a median of 2 mm Hg (P < 0.0001). Arch vessels were crossed in 31/42 proc (73.8\%). Periprocedural adverse events were encountered in 13/42 proc (30.9\%), predominately in patients with a weight below 10 kg or univentricular physiology. The median follow-up was 1 year (32 days - 3.8 years). The incidence of systemic hypertension was significantly reduced from 22/42 (52.4\%) before the procedure to 6/39 (15.4\%) at the most recent follow-up (P = 0.0005). CT or MRI evaluations were performed in 18 pts, documenting all crossed arch vessels to appear patent. CONCLUSIONS: Stenting of complex aortic arch lesions can be performed safely and effectively with excellent, immediate, and midterm results. Patients with a weight below 10 kg or after Hybrid stage I palliation are at increased risk of adverse events. Stents can be placed across major arch vessels without compromising distal perfusion in otherwise normal vasculature. (c) 2008 Wiley-Liss, Inc. This article was published in Catheter Cardiovasc Interv and referenced in Pediatrics & Therapeutics

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords