Immediate and long­term outcomes of native aortic coarctation and postsurgical aortic recoarctation treated with stent implantation: a single­center experience.

INTRODUCTION    Stent implantation has become the treatment of choice for native aortic coarctation (CoA) and postsurgical aortic recoarctation (reCoA) in adults and adolescents. OBJECTIVES    This study aimed to compare the immediate and long­term outcomes of patients with native CoA and postsurgical reCoA who underwent stent implantation in our center. PATIENTS AND METHODS    The data of 136 patients with native CoA and reCoA who underwent stent implantation between May 1999 and December 2016 were retrospectively analyzed. The study population was divided into 2 groups: 108 patients with native CoA and 28 patients with reCoA. Clinical and procedural characteristics and immediate and long­term outcomes after the intervention were compared between the groups. The use of antihypertensive drugs was analyzed in all patients. RESULTS    There were no significant differences in the clinical characteristics of the study groups. The gradient before the intervention was significantly higher in the native CoA than in the reCoA group (P = 0.011), and the diameter of stenosis before the intervention was smaller in the native CoA group compared with the ReCoA group (P = 0.003). Procedural treatment was successful in 77.8% of the patients with native CoA and 78.5% of those with reCoA. There were no differences in the immediate and long­term outcomes between the groups. The antihypertensive treatment was tapered or discontinued in about 34% of the study population. CONCLUSIONS    Stenting is an effective and safe procedure in patients with native CoA and reCoA, with good late outcomes.

New Indications for Vascular Occluders in Secondary Repairs of Complex Aortic Pathologies.

In the recent years, the application of vascular plugs has been widespread in peripheral and aortic interventions. Between December 2013 and December 2014, 4 men, with different complex aortic pathologies (2 remaining aortic dissections and 2 thoracoabdominal aneurysms), successfully underwent endovascular treatment with Amplatzer Vascular Plug (St. Jude; St. Paul, MN). We report the different techniques applied in each case and the benefits of this approach in achieving thrombosis of false lumen, avoiding aneurysmal aorta enlargement and reducing risk of aortic rupture or death. Neither mortality nor complications were registered during a mean follow-up of 18 months.