Acute, intermediate and long-term complications after aortic coarctation stenting

Abstract

Introduction

In native aortic coarctation, as well as recoarctation with appropriate anatomy, stenting has become the treatment of first choice according to European guidelines.

Objective

The objective of this study was to assess the safety as well as the short and long-term efficacy of percutaneous treatment of aortic coarctation/recoarctation in adults.

Methods

This study included all adult patients with a native or post-operative aortic coarctation treated percutaneously in a single center from March 2006 to December 2022. Baseline characteristics, intra-procedural and follow-up data were analyzed. The primary outcome was acute procedural success and secondary outcomes were intra-operative and late complications.

Results/Expected results

A total of 62 patients were included. The mean age was 35 years (range, 15–74), 33 (53.2%) patients were male. Thirty patients (48.3%) had a native aortic coarctation, 57 (91.9%) were hypertensive and 32 (51.6%) had a bicuspid aortic valve. Acute procedural success was achieved in all patients with a peak-to-peak gradient at the end of the procedure lower than 20 mmHg in 60 (96.7%) patients. Two (3.2%) patients had a non-fatal aortic rupture without sequelae and 2 (3.2%) had a false femoral aneurysm requiring intervention. At the follow-up visit, 55.3% patients had persistent arterial hypertension requiring medical treatment. Regarding late complications, 3 (4,8%) patients had aortic recoarctation that required a new percutaneous procedure, 1 (1,6%) patient had a type B aortic dissection that did not require invasive management, and 1 (1,6%) patient had a thrombosis of the right external iliac artery.

Conclusion/Perspectives

Percutaneous treatment with stenting of aortic coarctations in adults is safe and effective when performed in expert centers. Follow-up of this cohort will bring important data on very long-term outcomes associated with this technique.