| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 1995;92:893-897.)
© 1995 American Heart Association, Inc.
Articles |
Repeat Dilation of Intravascular Stents in Congenital Heart Defects
From Schneider Children's Hospital, Department of Pediatric Cardiology, New Hyde Park, NY (F.F.I.), and Texas Children's Hospital, Department of Pediatric Cardiology, Houston, Tex (R.G.G., M.R.N., C.E.M.).
Background Intravascular (Palmaz) stents have been successfully implanted in patients with congenital and acquired branch pulmonary stenosis. Early results are excellent; however, there is no information on restenosis and repeat dilation in patients with congenital heart disease. The purpose of this study is to review the incidence of restenosis and demonstrate the safety and efficacy of repeat dilation of stents in this group of patients.
Methods and Results Of 94 patients with 163 implanted stents in this single-center study, 43 patients with 73 implanted stents underwent recatheterization. Only 2 of 73 restudied stents (3%) developed significant restenosis. In 20 patients, 30 stents were redilated. At stent implantation, the mean age of this subgroup was 14.2 years, the mean intraluminal diameter increased from 4.9 to 10.7 mm (P=.0001), and the systolic gradient (mean) across the stent decreased from 52 to 11 mm Hg (P=.0001). At recatheterization (mean, 13 months), all stents were patent. The mean diameter decreased by 1.2 mm (P=.0001), but the increase in the gradient (mean, 3 mm Hg) was not significant (P=.11). After repeat dilation, the diameter increased from 9.5 to 12.2 mm (P=.0001), and the gradient decreased from 14 to 8 mm Hg (P=.0003). The 2 stents with restenosis were redilated successfully. Two patients underwent a successful second redilation of 3 stents at 18 and 26 months. There were no complications.
Conclusions All stents remained patent. The occurrence of significant restenosis is low (3%), and these restenoses can be redilated and/or restented. Repeat dilation of the Palmaz stent implanted in branch pulmonary artery stenosis can be performed with safety and efficacy (94% success rate) up to 3 years after stent implantation.
Key Words: stents • restenosis • heart defects • congenital
This article has been cited by other articles:
 |
|
 |
|
  D. E. Boshoff, N. Bethuyne, M. Gewillig, L. Mertens, B. Eyskens, I. Bakir, E. Verbeken, W. Daenen, and B. Meyns Endovascular stenting of juvenile vessels: consequence of surgical stent removal on vessel architecture Eur. Heart J., April 2, 2007; 28(8): 1033 - 1036. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Sigler, K Schneider, M Meissler, K Koenig, and M B E Schneider Breakable stent for interventions in infants and neonates: an animal study and histopathological findings Heart, February 1, 2006; 92(2): 245 - 248. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P Ewert, S Schubert, B Peters, H Abdul-Khaliq, N Nagdyman, and P E Lange The CP stent--short, long, covered--for the treatment of aortic coarctation, stenosis of pulmonary arteries and caval veins, and Fontan anastomosis in children and adults: an evaluation of 60 stents in 53 patients Heart, July 1, 2005; 91(7): 948 - 953. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Duke, E Rosenthal, and S A Qureshi The efficacy and safety of stent redilatation in congenital heart disease Heart, August 1, 2003; 89(8): 905 - 912. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C E Mullins Vessel restenosis versus "streamlining" Heart, December 1, 2002; 88(5): 445 - 446. [Full Text] [PDF]
|
|
|
|
|
|
M B E Schneider, P Zartner, K Duveneck, and P E Lange Various reasons for repeat dilatation of stented pulmonary arteries in paediatric patients Heart, December 1, 2002; 88(5): 505 - 509. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Peuster, P Wohlsein, M Brugmann, M Ehlerding, K Seidler, C Fink, H Brauer, A Fischer, and G Hausdorf A novel approach to temporary stenting: degradable cardiovascular stents produced from corrodible metal---results 6-18 months after implantation into New Zealand white rabbits Heart, November 1, 2001; 86(5): 563 - 569. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. J. McMahon, H. G. El-Said, R. G. Grifka, J. K. Fraley, M. R. Nihill, and C. E. Mullins Redilation of endovascular stents in congenital heart disease: factors implicated in the development of restenosis and neointimal proliferation J. Am. Coll. Cardiol., August 1, 2001; 38(2): 521 - 526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Ungerleider, T. A. Johnston, M. P. O'Laughlin, J. J. Jaggers, and P. R. Gaskin Intraoperative stents to rehabilitate severely stenotic pulmonary vessels Ann. Thorac. Surg., February 1, 2001; 71(2): 476 - 481. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. F. Ing, T. E. Fagan, R. G. Grifka, S. Clapp, M. R. Nihill, M. Cocalis, J. Perry, J. Mathewson, and C. E. Mullins Reconstruction of stenotic or occluded iliofemoral veins and inferior vena cava using intravascular stents: re-establishing access for future cardiac catheterization and cardiac surgery J. Am. Coll. Cardiol., January 1, 2001; 37(1): 251 - 257. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Funaki, J. D. Rosenblum, J. A. Leef, G. X. Zaleski, T. Farrell, J. Lorenz, and L. Brady Percutaneous Treatment of Portal Venous Stenosis in Children and Adolescents with Segmental Hepatic Transplants: Long-term Results Radiology, April 1, 2000; 215(1): 147 - 151. [Abstract] [Full Text]
|
|
|
|
|
|
Y.-f. Cheung, S. Sanatani, M. P. Leung, D. G. Human, A. K. T. Chau, and J. A. G. Culham Early and intermediate-term complications of self-expanding stents limit its potential application in children with congenital heart disease J. Am. Coll. Cardiol., March 15, 2000; 35(4): 1007 - 1015. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Fidler, J. P. Cheatham, S. E. Fletcher, A. B. Martin, J. D. Kugler, C. H. Gumbiner, and D. A. Danford CT Angiography of Complications in Pediatric Patients Treated with Intravascular Stents Am. J. Roentgenol., February 1, 2000; 174(2): 355 - 359. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Ovaert, C. A. Caldarone, B. W. McCrindle, D. Nykanen, R. M. Freedom, J. G. Coles, W. G. Williams, and L. N. Benson ENDOVASCULAR STENT IMPLANTATION FOR THE MANAGEMENT OF POSTOPERATIVE RIGHT VENTRICULAR OUTFLOW TRACT OBSTRUCTION: CLINICAL EFFICACY J. Thorac. Cardiovasc. Surg., November 1, 1999; 118(5): 886 - 893. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Gibbs, O. Uzun, M. E.C. Blackburn, C. Wren, J.R. L. Hamilton, and K. G. Watterson Fate of the Stented Arterial Duct Circulation, May 25, 1999; 99(20): 2621 - 2625. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. D. Allen, R. H. Beekman III, A. Garson Jr, Z. M. Hijazi, C. Mullins, M. P. O'Laughlin, and K. A. Taubert Pediatric Therapeutic Cardiac Catheterization : A Statement for Healthcare Professionals From the Council on Cardiovascular Disease in the Young, American Heart Association Circulation, February 17, 1998; 97(6): 609 - 625. [Full Text] [PDF]
|
|
|
|
 |
|
 K. P WALSH Interventional cardiology Arch. Dis. Child., January 1, 1997; 76(1): 6 - 8. [Full Text]
|
|
|
|
|
|
A. N. Redington and J. Somerville Stenting of Aortopulmonary Collaterals in Complex Pulmonary Atresia Circulation, November 15, 1996; 94(10): 2479 - 2484. [Abstract] [Full Text]
|
|