Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries

Initial results and long-term follow up

Gary E. Stapleton, Rabih Hamzeh, Charles E. Mullins, Thomas M. Zellers, Henri Justino, Alan Nugent, Michael R. Nihill, Ronald G. Grifka, Frank Ing

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Balloon angioplasty of bifurcating pulmonary artery (PA) stenoses is often inadequate, and stent treatment often requires simultaneous implantation of two stents. This study evaluates initial results and long-term follow up of transcatheter stent placement in bifurcating PAs. Methods: This is a retrospective review of patients (pts) who had bifurcating PA stents placed in main and lobar branches from 1993 to 2007. Results: Forty-nine pts had bifurcating PA stents placed at a median age of 10.9 years (range 1-43 years). The mean minimum vessel diameter increased from 5.7 ± 2.5 mm to 11.0 ± 3.6 mm (P < 0.001), the mean gradient across the stenoses decreased from 37.0 ± 26.9 to 9.2 ± 13 mm Hg (P < 0.001), whereas the mean RV:FA ratio decreased from 0.76 ± 0.29 to 0.53 ± 0.24 (P < 0.001). There was one death due to severe pulmonary hemorrhage. F/U data were available in 38 pts (mean duration 6.3 ± 4.1 years, range 1.2-13.1 years). Thirty pts underwent repeat catheterizations (mean 2.3 ± 2.2 years poststent), with 26 requiring further interventions: Fifteen had balloon angioplasty alone and 11 had additional stents placed. There were no complications at f/u catheterization. Six pts underwent further palliative surgeries, although none for repair of branch PA stenoses. Conclusions: Simultaneous transcatheter placement of bifurcating PA stents provides immediate gradient relief of bifurcating stenoses in the proximal or lobar branch PAs and reduces RV systolic pressure. Further interventions can be safely performed in future procedures, and the presence of stents does not complicate future surgeries.

Original languageEnglish (US)
Pages (from-to)557-563
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume73
Issue number4
DOIs
StatePublished - Mar 1 2009
Externally publishedYes

Fingerprint

Stents
Pulmonary Artery
Balloon Angioplasty
Catheterization
Pathologic Constriction
Pulmonary Artery Stenosis
Palliative Care
Hemorrhage
Blood Pressure
Lung

Keywords

  • Bifurcating stents
  • Cardiac catheterization
  • Pulmonary artery stenoses

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries : Initial results and long-term follow up. / Stapleton, Gary E.; Hamzeh, Rabih; Mullins, Charles E.; Zellers, Thomas M.; Justino, Henri; Nugent, Alan; Nihill, Michael R.; Grifka, Ronald G.; Ing, Frank.

In: Catheterization and Cardiovascular Interventions, Vol. 73, No. 4, 01.03.2009, p. 557-563.

Research output: Contribution to journalArticle

Stapleton, Gary E. ; Hamzeh, Rabih ; Mullins, Charles E. ; Zellers, Thomas M. ; Justino, Henri ; Nugent, Alan ; Nihill, Michael R. ; Grifka, Ronald G. ; Ing, Frank. / Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries : Initial results and long-term follow up. In: Catheterization and Cardiovascular Interventions. 2009 ; Vol. 73, No. 4. pp. 557-563.
@article{7ff5c4bcb08d42078a896d0b76ebb781,
title = "Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries: Initial results and long-term follow up",
abstract = "Background: Balloon angioplasty of bifurcating pulmonary artery (PA) stenoses is often inadequate, and stent treatment often requires simultaneous implantation of two stents. This study evaluates initial results and long-term follow up of transcatheter stent placement in bifurcating PAs. Methods: This is a retrospective review of patients (pts) who had bifurcating PA stents placed in main and lobar branches from 1993 to 2007. Results: Forty-nine pts had bifurcating PA stents placed at a median age of 10.9 years (range 1-43 years). The mean minimum vessel diameter increased from 5.7 ± 2.5 mm to 11.0 ± 3.6 mm (P < 0.001), the mean gradient across the stenoses decreased from 37.0 ± 26.9 to 9.2 ± 13 mm Hg (P < 0.001), whereas the mean RV:FA ratio decreased from 0.76 ± 0.29 to 0.53 ± 0.24 (P < 0.001). There was one death due to severe pulmonary hemorrhage. F/U data were available in 38 pts (mean duration 6.3 ± 4.1 years, range 1.2-13.1 years). Thirty pts underwent repeat catheterizations (mean 2.3 ± 2.2 years poststent), with 26 requiring further interventions: Fifteen had balloon angioplasty alone and 11 had additional stents placed. There were no complications at f/u catheterization. Six pts underwent further palliative surgeries, although none for repair of branch PA stenoses. Conclusions: Simultaneous transcatheter placement of bifurcating PA stents provides immediate gradient relief of bifurcating stenoses in the proximal or lobar branch PAs and reduces RV systolic pressure. Further interventions can be safely performed in future procedures, and the presence of stents does not complicate future surgeries.",
keywords = "Bifurcating stents, Cardiac catheterization, Pulmonary artery stenoses",
author = "Stapleton, {Gary E.} and Rabih Hamzeh and Mullins, {Charles E.} and Zellers, {Thomas M.} and Henri Justino and Alan Nugent and Nihill, {Michael R.} and Grifka, {Ronald G.} and Frank Ing",
year = "2009",
month = "3",
day = "1",
doi = "10.1002/ccd.21838",
language = "English (US)",
volume = "73",
pages = "557--563",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",
number = "4",

}

TY - JOUR

T1 - Simultaneous stent implantation to treat bifurcation stenoses in the pulmonary arteries

T2 - Initial results and long-term follow up

AU - Stapleton, Gary E.

AU - Hamzeh, Rabih

AU - Mullins, Charles E.

AU - Zellers, Thomas M.

AU - Justino, Henri

AU - Nugent, Alan

AU - Nihill, Michael R.

AU - Grifka, Ronald G.

AU - Ing, Frank

PY - 2009/3/1

Y1 - 2009/3/1

N2 - Background: Balloon angioplasty of bifurcating pulmonary artery (PA) stenoses is often inadequate, and stent treatment often requires simultaneous implantation of two stents. This study evaluates initial results and long-term follow up of transcatheter stent placement in bifurcating PAs. Methods: This is a retrospective review of patients (pts) who had bifurcating PA stents placed in main and lobar branches from 1993 to 2007. Results: Forty-nine pts had bifurcating PA stents placed at a median age of 10.9 years (range 1-43 years). The mean minimum vessel diameter increased from 5.7 ± 2.5 mm to 11.0 ± 3.6 mm (P < 0.001), the mean gradient across the stenoses decreased from 37.0 ± 26.9 to 9.2 ± 13 mm Hg (P < 0.001), whereas the mean RV:FA ratio decreased from 0.76 ± 0.29 to 0.53 ± 0.24 (P < 0.001). There was one death due to severe pulmonary hemorrhage. F/U data were available in 38 pts (mean duration 6.3 ± 4.1 years, range 1.2-13.1 years). Thirty pts underwent repeat catheterizations (mean 2.3 ± 2.2 years poststent), with 26 requiring further interventions: Fifteen had balloon angioplasty alone and 11 had additional stents placed. There were no complications at f/u catheterization. Six pts underwent further palliative surgeries, although none for repair of branch PA stenoses. Conclusions: Simultaneous transcatheter placement of bifurcating PA stents provides immediate gradient relief of bifurcating stenoses in the proximal or lobar branch PAs and reduces RV systolic pressure. Further interventions can be safely performed in future procedures, and the presence of stents does not complicate future surgeries.

AB - Background: Balloon angioplasty of bifurcating pulmonary artery (PA) stenoses is often inadequate, and stent treatment often requires simultaneous implantation of two stents. This study evaluates initial results and long-term follow up of transcatheter stent placement in bifurcating PAs. Methods: This is a retrospective review of patients (pts) who had bifurcating PA stents placed in main and lobar branches from 1993 to 2007. Results: Forty-nine pts had bifurcating PA stents placed at a median age of 10.9 years (range 1-43 years). The mean minimum vessel diameter increased from 5.7 ± 2.5 mm to 11.0 ± 3.6 mm (P < 0.001), the mean gradient across the stenoses decreased from 37.0 ± 26.9 to 9.2 ± 13 mm Hg (P < 0.001), whereas the mean RV:FA ratio decreased from 0.76 ± 0.29 to 0.53 ± 0.24 (P < 0.001). There was one death due to severe pulmonary hemorrhage. F/U data were available in 38 pts (mean duration 6.3 ± 4.1 years, range 1.2-13.1 years). Thirty pts underwent repeat catheterizations (mean 2.3 ± 2.2 years poststent), with 26 requiring further interventions: Fifteen had balloon angioplasty alone and 11 had additional stents placed. There were no complications at f/u catheterization. Six pts underwent further palliative surgeries, although none for repair of branch PA stenoses. Conclusions: Simultaneous transcatheter placement of bifurcating PA stents provides immediate gradient relief of bifurcating stenoses in the proximal or lobar branch PAs and reduces RV systolic pressure. Further interventions can be safely performed in future procedures, and the presence of stents does not complicate future surgeries.

KW - Bifurcating stents

KW - Cardiac catheterization

KW - Pulmonary artery stenoses

UR - http://www.scopus.com/inward/record.url?scp=65549089122&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=65549089122&partnerID=8YFLogxK

U2 - 10.1002/ccd.21838

DO - 10.1002/ccd.21838

M3 - Article

VL - 73

SP - 557

EP - 563

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 4

ER -