International Journal of Cardiology 184 (2015) 483
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Percutaneous treatment of aortic coarctation with new generation self expandable stent system and the images of 320-slice tomographic angiography☆ Mehmet Gungor Kaya, Serhat Karadavut ⁎ Erciyes University School of Medicine, Department of Cardiology, Kayseri, Turkey
a r t i c l e
i n f o
Article history: Received 17 January 2015 Accepted 27 February 2015 Available online 28 February 2015 Keywords: Aortic coarctation 320-slice computed tomography Self-expandable stent
changes before and after treatment in coarcted segment (Fig. 1C and D, yellow arrows). Coarcted aortic region diameter was measured 11 mm. Upper and lower limb blood pressure was measured 130/ 70 and 145/80 mm Hg, respectively. Intravascular stent therapy for aorta coarctation is widely accepted method. However procedure is commonly safe and not complicated, several conditions like long coarcted segment and aneurymatic segment after coarctation make procedure more difficult. In our case, we successfully implanted stent covering both long coarcted and aneurysmatic segments. XL self-expandable stent is a new generation and the worldwide first stent system with class III registration for stenosis, dissections of the aorta and obstructions of the vena cava.
A previously well 20-year-old woman presented with a 2-month history of headaches and tinnitus. Upper limb blood pressure was 210/90 mm Hg on physical examination. Auscultation revealed 2/6 pan-systolic murmur under the left scapula. Non-palpable lower extremity pulses were determined and blood pressure was measured 100/55 mm Hg. 320-Slice computed tomographic (CT) angiography showed a coarctation of the descending thoracic aorta which was 2 mm in diameter at the narrowest part. An aneurysmal segment existed after coarcted aorta. Cardiac catheterization revealed 70 mm Hg peak gradient across the coarcted segment. Amplatzer stiff guide-wire was advanced through the narrowing segment (Fig. 1A). 26 × 60 mm Sinus XL self-expandable stent (Optimed, Inc., Ettlingen, Germany) was placed and subsequently dilated with 10 × 40 mm Pyxis-V balloon (QualiMed, Inc., Winsen, Germany), restoring blood flow (Fig. 1B). Post-procedure gradient was measured 0 mm Hg. Acetylsalicylic acid, clopidogrel and beta blocker were prescribed. The patient recovered and was discharged after 2 days of hospitalization. One month later, control CT angiography showed
☆ Conflict of interest: None. ⁎ Corresponding author at: Erciyes University School of Medicine Department of Cardiology, 38039 Kayseri, Turkey. E-mail address: [email protected] (S. Karadavut).
http://dx.doi.org/10.1016/j.ijcard.2015.02.110 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
Fig. 1. Opaque injection viewing the coarcted segment of the descending thoracic aorta (A), post-process fluoroscopic image of the self-expandable stent (B), Pre-procedure and post-procedure 320-slice CT angiographic images (C, D).
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Percutaneous treatment of aortic coarctation with new generation self expandable stent system and the images of 320-slice tomographic angiography☆ Mehmet Gungor Kaya, Serhat Karadavut ⁎ Erciyes University School of Medicine, Department of Cardiology, Kayseri, Turkey
a r t i c l e
i n f o
Article history: Received 17 January 2015 Accepted 27 February 2015 Available online 28 February 2015 Keywords: Aortic coarctation 320-slice computed tomography Self-expandable stent
changes before and after treatment in coarcted segment (Fig. 1C and D, yellow arrows). Coarcted aortic region diameter was measured 11 mm. Upper and lower limb blood pressure was measured 130/ 70 and 145/80 mm Hg, respectively. Intravascular stent therapy for aorta coarctation is widely accepted method. However procedure is commonly safe and not complicated, several conditions like long coarcted segment and aneurymatic segment after coarctation make procedure more difficult. In our case, we successfully implanted stent covering both long coarcted and aneurysmatic segments. XL self-expandable stent is a new generation and the worldwide first stent system with class III registration for stenosis, dissections of the aorta and obstructions of the vena cava.
A previously well 20-year-old woman presented with a 2-month history of headaches and tinnitus. Upper limb blood pressure was 210/90 mm Hg on physical examination. Auscultation revealed 2/6 pan-systolic murmur under the left scapula. Non-palpable lower extremity pulses were determined and blood pressure was measured 100/55 mm Hg. 320-Slice computed tomographic (CT) angiography showed a coarctation of the descending thoracic aorta which was 2 mm in diameter at the narrowest part. An aneurysmal segment existed after coarcted aorta. Cardiac catheterization revealed 70 mm Hg peak gradient across the coarcted segment. Amplatzer stiff guide-wire was advanced through the narrowing segment (Fig. 1A). 26 × 60 mm Sinus XL self-expandable stent (Optimed, Inc., Ettlingen, Germany) was placed and subsequently dilated with 10 × 40 mm Pyxis-V balloon (QualiMed, Inc., Winsen, Germany), restoring blood flow (Fig. 1B). Post-procedure gradient was measured 0 mm Hg. Acetylsalicylic acid, clopidogrel and beta blocker were prescribed. The patient recovered and was discharged after 2 days of hospitalization. One month later, control CT angiography showed
☆ Conflict of interest: None. ⁎ Corresponding author at: Erciyes University School of Medicine Department of Cardiology, 38039 Kayseri, Turkey. E-mail address: [email protected] (S. Karadavut).
http://dx.doi.org/10.1016/j.ijcard.2015.02.110 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
Fig. 1. Opaque injection viewing the coarcted segment of the descending thoracic aorta (A), post-process fluoroscopic image of the self-expandable stent (B), Pre-procedure and post-procedure 320-slice CT angiographic images (C, D).
