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Stent implantation for severe pulmonary vein stenosis or occlusion secondary to atrial fibrillation ablation
کاشت استنت برای تنگی شدید ورید ریوی یا انسداد ثانویه تا فرسایش فیبریلاسیون دهلیزی-2020 Background: Catheter interventional treatment of pulmonary vein stenosis or occlusion (PVS/O) following radiofrequency
ablation (RFA) for atrial fibrillation (AF) remains a challenging field due to lacking randomized data
and there are limited data about stenting.
Methods: All patients at our center who underwent pulmonary vein stenosis (PVS) stenting for PVS/O induced by
RFA were retrospectively assessed. Clinical presentation, anatomic site of stenosis and hemodynamic information,
as well as follow-up data, were collected and analyzed.
Results: FromJanuary 2010 to June 2018, 56 patients with PVS/O secondary to RFA were treated with 113 stents.
Procedural success rate was 95.8%. Pressure gradients significantly reduced (p b 0.001) and vessel caliber markedly
increased (p b 0.001) in all the stenotic sites, with immediate symptoms significantly improved. The overall
in-stent restenosis (ISR) rate was 21.8% after amedian follow-up period of 26 months (interquartile range: 16 to
35.5 months). The incidence of ISR was higher in patients treated with stent diameter ≤ 8 mm than those with
stent diameter N8 mm (HR: 3.91; 95% CI 1.74–8.81; p = 0.001).
Conclusions: PVS stenting is a safe and effective procedure for PVS/O secondary to RFA. Long-term patency and
good clinical outcomes are gained after bigger-diameter stent implantation Keywords: Atrial fibrillation | Pulmonary vein stenosis | Radiofrequency ablation | Stent |
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