Aortic coarctation stenting

Overview
Re-coarctation may be treated with either percutaneous balloon dilation or percutaneous stent placement.

Primary Percutaneous Treatment of Native Coarctation
Balloon dilation can be used to treat unrepaired native coarctation, but it is generally avoided in the first 6 to 12 months of life due to potential vascular complications and a high rate of re-coarctation. As primary treatment, there is a high risk of aortic rupture compared to recoarctation in which case there is scar tissue. . Aortic aneurysm formation is another potential complication following balloon dilation or surgery. Despite the thickening in the area of coarctation, these patients have abnormally weak aortas and may have cystic medial necrosis in the areas surrounding the coarctation.

Percutaneous Treatment of Coarctation Following Initial Repair
Percuataneous balloon dilation is associated with lower morbidity than surgical repair and is viewed as the primary mode of treating re-coarctation. Although the risk of aortic rupture is lower than in primary balloon dilation of coarctation, there is a low but finite risk of balloon rupture.

Stent implantation has been advocated as a means to reduce the risk of aortic rupture, aortic dissection, recoil, and subsequent aortic aneurysm formation associated with balloon dilation. Complications include inability to fully dilated the stent and retroperitoneal bleeding. Stenting reduced the incidence of hypertension from 71% before the procedure to 26% following the procedure in one study. The incidence of late aortic aneurysm formation is not known.