Stent Use in Coarctation of the Aorta - summitMD.com

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Interventional options: Based on anatomy • Discrete – Angioplasty first option – Stent if residual gradient • Long segment – Stent – If severe, test dilation with low pressure balloon • Kink/fold – Need stent to straighten out aorta • Arch, thoracic, abdominal COA – Usually long segment; need stent – Adjacent to major arterial side branches
Interventional options: Based on patient size & aorta diameter • Patient size ≤ 25 kg – Femoral arteries may be too small to accommodate large sheath (minimal 9 Fr sheath) – Femoral artery angiogram to evaluate size – Angioplasty first option • Normal diameter adjacent to COA ≤10mm – Angioplasty first – Insufficient long term data to prove that stents dilated < 10 mm can to serially dilated to adult size (at least 18 mm diam) • In extreme cases (ie, poor surgical candidates), will stent if angioplasty inadequate – Use medium size stents on smaller balloons – Will require future surgical removal
Page 1 and 2: • BAYLOR COLLEGE OF MEDICINE •
Page 3 and 4: • Ridge like medial thickening, u
Page 5: Coarctation / recoarctation of the
Page 9 and 10: COA- Stent implantation: Complicati
Page 11 and 12: Palmaz XL Dilated w/ 24 mm BIB Undi
Page 13 and 14: EV3 MaxLD- serial dilation w/ 18 mm
Page 15 and 16: MaxLD 24 mm expansion Variable leng
Page 17 and 18: Coarctation of the Aorta • Balloo
Page 19 and 20: Pre & post dilation angiogram Lat p
Page 21 and 22: Aortic diameter changes with a puls
Page 23 and 24: Comparison of aortograms Pre-dilati
Page 25 and 26: 25 yr. F w/ severe pre-eclampsia du
Page 27 and 28: Dynamic posterior bend
Page 29 and 30: Pre & post lat angiogram QuickTime?
Page 31 and 32: Stent straighten out the S-bend Ste
Page 33 and 34: Severe coarctation of the aorta-(vi
Page 35 and 36: Test dilation w/ 10 mm low pressure
Page 37 and 38: Pre and post stent angiograms AP Pr
Page 39 and 40: Multiple views may be needed to vie
Page 41 and 42: Stent implantation Stent #1 MaxLD16
Page 43 and 44: Post implantation of 2 stents (P308
Page 45 and 46: Implantation of 2 additional stents
Page 47 and 48: Neurofibromatosis w/ mid-aortic syn
Page 49 and 50: Pre and post angios Pre Post
Page 51 and 52: Implant stent jailed left renal art
Page 53 and 54: 6 month F/U cath: recoarctation Goo
Page 55 and 56: Pre and post angiograms Bilateral j
Page 57 and 58:
Coarctation-pre stent 14 yoF s/p CO
Page 59 and 60:
CT Angiogram
Page 61 and 62:
Palmaz XL stent - cell dilation w/
Page 63 and 64:
25 yo w/ systemic hypertension: Lon
Page 65 and 66:
Maneuvers to reposition stent With
Page 67 and 68:
COA stenting can be technically dif
Page 69 and 70:
Balloon inflation only after stent
Page 71 and 72:
Coarctation of the aorta
Page 73 and 74:
Post-dilation of Coarctation
Page 75 and 76:
5 year F/U CT angio Aneurysm at sid
Page 77 and 78:
Covered stents
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Stent Use in Coarctation of the Aorta - summitMD.com

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