Safety and Efficacy of Endovascular Treatment of Middle Aortic Syndrome with Self-expanding Stent: A Single-center Experience
Girish R Sabnis, Charan P Lanjewar, Rish A Bhargava, Devendra V Patil, Sunny Shinde, Mayank Agarwal, Hetan C Shah, Prafulla G Kerkar
OBJECTIVE: To determine the immediate procedural outcome of self-expanding stent implantation in patients with the middle aortic syndrome. STUDY DESIGN: Retrospective observational study. MATERIALS AND METHODS: Five patients, aged 15 to 17 years (mean 26.2 years), with upper limb hypertension due to middle aortic syndrome and receiving endovascular treatment with self-expanding stent in the Department of Cardiology at a major tertiary center in Western India were analyzed. INTERVENTION: Self-expanding stents were implanted in the mid/ lower thoracic/upper abdominal aorta. MAIN OUTCOME MEASURE: Satisfactory deployment of stents with 50% or greater reduction in pressure gradient and incidence of periprocedural complications. RESULTS: In all patients, angiography showed long-segment stenosis in the mid or lower thoracic/upper abdominal aorta. The pressure gradient was between 51 and 140 mm Hg (mean 92.4 mm Hg). Five self-expanding stents were implanted. Immediately after implantation, the gradient decreased to between 16 and 55 mm Hg (mean 37.2 mm Hg). Angiography showed a satisfactory result with widely patent stents in all. There were no major periprocedural complications. CONCLUSION: Endovascular self-expandable stent implantation is a safe and feasible modality for the treatment of patients with the middle aortic syndrome and merits further evaluation in larger number of patients with greater follow-up.
Endovascular management, Middle aortic syndrome, Self-expanding stent, Takayasuâ€™s disease.