Comparing balloon angioplasty, stenting and surgery in the treatment of aortic coarctation.

This article summarizes the currently available data regarding the management of coarctation, comparing balloon angioplasty, surgery and transcatheter stent therapy. The vast majority of reported studies are retrospective institutional series and comparative prospective studies are scarce, making it difficult to clearly recommend a treatment strategy. Long-term data are lacking, with most studies evaluating transcatheter approaches having a median follow-up of 5 years or less. Surgical repair is recommended for most patients with duct-dependent neonatal coarctation, while stent implantation for older children and adults has been shown to have excellent short-term results. Balloon angioplasty for (native) coarctation is effective in leading to an acute gradient reduction, but has been found to have a higher incidence of recoarctation or aortic wall complications. Long-term data from prospective registries, such as the Comprehensive, Continuous, Integrated System of Care (CCISC), are required before being able to make more firm recommendations upon the most appropriate treatment algorithm.