ABSTRACT
Introduction Stent implantation in aortic coarctation is increasingly used to treat patients who would previously have been treated by balloon angioplasty or surgery. Balloon dilation in native aortic coarctation and recoarctation has been controversial since its introduction in 1982.1 Histologic and intravascular ultrasound studies2-6 have demonstrated that the mechanism of angioplasty involves tearing of the intima and media. Deficient elastic and muscular lamella have been noted in ballooned sections of aorta at the time of surgery.7
Although some of the intimal and medial tears may heal, there is concern that some may progress to aneurysms. Cystic medial necrosis may exist in the coarctation segment, suggesting that the aortic wall may be weak at the point of the stenosis.8 A relatively high incidence of aneurysm formation of 2-20% has been reported.9-13
