OBJECTIVES: This study sought to evaluate the use of covered Cheatham-platinu m(CP) stents in the treatment of aortic coarctation(CoA). BACKGROUND: Aortic ane urysms and stent fractures have been encountered after surgical and transcathete r treatment for CoA. Covered stents have previously been used in the treatment o f abdominal and thoracic aneurysms in adults. We implanted covered CP stents as a rescue treatment in patients with CoA aneurysms or previous stent-related com plications and in patients at risk of developing complications because of comple x CoA anatomy or advanced age. METHODS: Thirtythree covered CP stents were impla nted in 30 patients; 16 patients had had previous procedures. The remaining pati ents had complex or near-atretic CoA. RESULTS: The mean patient age and weight were 28(±17.5) years(range 8 to 65 years), and 62(±13) kg(range 28 to 86 kg), respectively. The systolic gradient across the CoA decreased from a mean(±SD) o f 36±20 mm Hg before to a mean of 4±4 mmHg after the procedure(p< 0.0001), and the diameter of the CoA increased from 6.4±3.8 mm to 17.1±3.1 mm(p< 0.0001). The follow-up period was up to 40 months(mean, 11 months). All stents were pate nt and in good position on computed tomography or magnetic resonance imaging per formed three to six months later. In 43%of the patients antihypertensive medica tion was either decreased or stopped. CONCLUSIONS: Covered CP stents may be used as the therapy of choice in patients with complications after CoA repairs, wher eas they provide a safe alternative to conventional stenting in patients with se vere and complex CoA lesions or advanced age.
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