AORTIC COARCTATION stenting achieves the desired lumen diameter in most neonatal tissue samples, according to a new ex vivo investigation.
Endovascular stenting has become the standard treatment for native coarctation of the aorta (CoA) in children and young adults because it is less invasive and associated with faster recovery. However neonatal CoA continues to be managed surgically due to concerns about vessel regrowth and available stent design limitations
While plain old balloon angioplasty (POBA) has previously been used in neonatal cases but concerns about vessel injury and aneurysm formation have restricted its wider adoption.
Balloon Angioplasty Requires Extensive Stretch
To investigate tissue responses during intervention, researchers performed balloon angioplasty and stenting on neonatal CoA samples obtained during surgery. Deformation was visualised using ultrasound guidance, while collagen hybridising peptide was used to quantify collagen damage post-treatment.
The researchers observed that balloon angioplasty alone was unable to maintain vessel patency. Without sufficient stretch, causing permanent deformation, the tissue did not maintain the intended lumen diameter following the procedure.
Conversely five of six neonatal aortic coarctation samples were successfully treated with stent implantation, with no stent failures reported. The researchers determined that stenting was a viable approach for achieving desired lumen diameter in the tested tissue samples.
Collagen Damage Observed Following Both Interventions
The study also highlighted the highly heterogeneous nature of neonatal aortic coarctation tissue, with marked variation in collagen and elastin content across samples. Researchers noted that these microstructural differences appeared to influence tissue response to intervention, suggesting that treatment strategies may benefit from considering individual tissue composition when planning stent deployment.
Despite stenting’s success, analysis showed that both balloon angioplasty and stenting caused considerable collagen damage to the tissue samples. Researchers concluded that although stenting effectively restored lumen size, there would need to be procedural strategies to account for the associated microstructural injury.
The study’s authors propose that future stenting procedures should consider implementing an incremental approach to stent expansion to help reduce microstructural collagen damage and potential aneurysm risk.
Reference
Linnane N et al. Quantitative assessment of microstructural damage in paediatric aortic coarctation tissue during benchtop balloon angioplasty and stenting. Sci Rep. 2026; DOI: 10.1038/s41598-026-57357-w
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