Endovascular stenting for coarctation of the aorta in Infants and young children in southeast Iran: A retrospective study.

Abstract

Background: Coarctation of the aorta (CoA) in infants and young children is typically treated with high-risk open-heart surgery. Endovascular stenting provides a less invasive alternative; however, its safety and efficacy remain underexplored. This study aimed to evaluate procedural success, complications, and four-year outcomes of stenting for CoA.

Methods: A retrospective review included 30 infants and young children (28 days to 3 years of age, weight >2.5 kg) with CoA who underwent endovascular stenting in Kerman and Sistan-Baluchestan, Iran, from 2024 to 2025. Patients with complex heart defects requiring immediate surgery or weighing <2.5 kg were excluded. Diagnostics utilized echocardiography, femoral angiography (for gradient assessment), and CT angiography. Outcomes included reduction in gradient, minor complications (hematoma, transient arrhythmia, localized bleeding, and bruising), major complications (stent thrombosis, vascular rupture, stent migration, vascular injury, sepsis, and mortality), and stent patency.

Results: Procedural success was achieved in 27 out of 30 patients (90%, 95% CI: 73.5-97.9%). The mean gradient was reduced by 89% (from 45 ± 10 mmHg to 5 ± 3 mmHg, p<0.001). Minor complications occurred in 3 of 30 patients (10%; 95% CI: 2.1-26.5%), including 2 hematomas and 1 transient arrhythmia; no major complications or mortality were reported. Four-year stent patency was 90% (95% CI: 73.5-97.9%); 3 out of 30 patients (10%) required re-dilation at 2.5 years due to growth. Cox regression analysis found no predictors for re-intervention (p>0.05).

Conclusion: Endovascular stenting seems to be a safe and effective alternative for CoA in infants and young children. Larger prospective studies are necessary.