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Revascularization of Left Subclavian to Common Carotid Artery Prepares for Covered Stent Implantation in Patients With Complex Aortic Coarctation.

Anastasia SchleigerJörg MichelPeter KramerSemih BuzBjörn PetersJoachim PhotiadisFelix BergerJohannes NordmeyerStephan Schubert
Published in: Innovations (Philadelphia, Pa.) (2022)
Seven adult patients underwent a two-stage treatment of complex coarctation (CoA), including surgical revascularization of the left subclavian artery (LSA) to left common carotid artery (LCCA), followed by transcatheter covered stent implantation. The majority of patients (5 of 7, 71%) received 1 covered stent (covered Cheatham Platinum stent: 8 zig/45 mm [ n  = 2], 10 zig/60 mm [ n  = 1], 10 zig/65 mm [ n  = 1]; BeGraft: 24/48 mm [ n  = 2]). In 1 patient (14%), the implantation of 2 covered stents (BeGraft 20/48 mm) was necessary. During a median follow-up of 2.4 years (interquartile range, 0.1 to 4.9 years), complications occurred in 3 of 7 patients (43%), including an asymptomatic but severe stenosis of the LSA bypass ( n  = 1), a recoarctation with a mild endoleak ( n  = 1), and a severe endoleak ( n  = 1). Surgical revascularization of the LSA to the LCCA can successfully prepare for covered stent implantation in complex CoA in adult patients. This two-stage approach was feasible and safe with complications occurring in 3 of 7 patients (43%). All complications were managed by catheter reintervention only.
Keyphrases
  • end stage renal disease
  • ejection fraction
  • chronic kidney disease
  • newly diagnosed
  • early onset
  • patient reported outcomes
  • coronary artery disease
  • acute coronary syndrome
  • abdominal aortic aneurysm