Results of Transcatheter Therapy with Balloon Versus Stent for Treating Isolated Branch Pulmonary Artery Stenosis in Children and Adolescents: A Midterm Study

IF 0.4 4区 医学 Q4 PEDIATRICS
Mohammadreza Edraki, Zhaleh Ataei, Nima Mehdizadegan, Hamid Amoozgar, Hamid Mohammadi, Amir Naghshzan
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引用次数: 0

Abstract

Background: Branch pulmonary artery stenosis presents as either an isolated disease or in association with congenital heart diseases (in 2 - 3% of cases). Balloon angioplasty (BA) and stent implantation (SI) are two percutaneous methods that are commonly used to treat this condition. We compared the outcomes of these 2 methods in children and adolescents with isolated branch pulmonary artery stenosis. Methods: Pediatric patients with severe branch pulmonary artery stenosis who were referred to our center and underwent transcatheter insertion via either BA or SI between 2010 and 2019 were studied. Patients’ demographic data, including age, gender, and body weight, were recorded. Standard procedures for BA and SI were applied. Post-procedure angiography and echocardiographic parameters were determined and compared between the 2 groups. Patients who were followed up for at least 2 years were selected for this study, and comparative evaluations were performed during the follow-up. Results: Forty patients with a median age of 2.1 years and a median weight of 10 kg were enrolled in the study, of whom 25 and 15 underwent BA and SI, respectively. The trans-stenotic pulmonary artery pressure gradient significantly reduced immediately after both procedures, but there was no significant difference between the BA and SI groups in terms of pulmonary artery pressure gradient early after the procedures (P-value = 0.014). There was a significant decline in the peak right ventricular pressure after both procedures. Restenosis occurred more frequently in the BA group. In the BA group, patients under one year old and weight lower than 10 kg had a lower restenosis recurrence rate, evidenced by echocardiographic measurements, compared to those with a weight over 10 kg. Three patients (12%) in the BA group needed balloon reinsertion. Conclusions: Immediate therapeutic success was similar between BA and SI in patients with branch pulmonary artery stenosis. Re-stenosis occurred more often in the BA group; however, the chance of re-stenosis was lower among patients weighing less than 10 kg over a 2-year follow-up.
经导管球囊与支架治疗儿童和青少年孤立性肺动脉分支狭窄的结果:一项中期研究
背景:肺动脉分支狭窄表现为一种孤立疾病或与先天性心脏病相关(2 - 3%的病例)。球囊血管成形术(BA)和支架植入术(SI)是两种常用的经皮治疗方法。我们比较了这两种方法治疗孤立性肺动脉分支狭窄的儿童和青少年的结果。方法:研究2010年至2019年期间转介至本中心并经BA或SI经导管插入的严重肺动脉分支狭窄患儿。记录患者的人口统计数据,包括年龄、性别和体重。采用BA和SI的标准程序。测定两组患者术后血管造影和超声心动图参数并进行比较。本研究选择随访2年以上的患者,并在随访期间进行比较评价。结果:40例中位年龄为2.1岁,中位体重为10 kg的患者入组研究,其中25例和15例分别接受了BA和SI。两组术后经狭窄肺动脉压力梯度均显著降低,但BA组与SI组术后早期肺动脉压力梯度差异无统计学意义(p值= 0.014)。两种手术后右心室压力峰值均显著下降。BA组再狭窄发生率较高。在BA组中,超声心动图测量显示,一岁以下体重低于10kg的患者与体重超过10kg的患者相比,再狭窄复发率较低。BA组3例(12%)患者需要球囊再插入。结论:BA和SI治疗肺动脉分支狭窄患者的即时治疗成功率相似。BA组再狭窄发生率较高;然而,在2年的随访中,体重小于10kg的患者再次狭窄的几率较低。
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来源期刊
CiteScore
0.90
自引率
20.00%
发文量
75
审稿时长
6-12 weeks
期刊介绍: Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.
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