Letters to the editor
Stenting for middle aortic syndrome
| The first 150 words of the full text of this article appear below. |
EDITOR,
Most of the patients in the article
"Stenting for middle aortic syndrome" by
Rajszys et al had long lesions with
significant peak systolic gradients across the stenotic segment.
Primary stenting of the lesions significantly reduced the peak systolic
gradients.1 We fail to understand the authors' preference
for anticoagulants over ticlopidine. Studies have consistently shown
that use of antithrombotic drugs are far superior to anticoagulants,
not only in lowering the incidence of stent thrombosis but also in
preventing bleeding complications.2 The use of
anticoagulants has largely been abandoned worldwide, even in coronary
vessels, which have much smaller luminal diameters and lower flow rates
compared with the aorta where the risk of thrombosis is low because of
large lumen and higher flow rates.
Second, Rajszys et al deployed the Palmaz
Schatz stents suboptimally to avoid overdilatation of aorta, repeating
the procedure after the intimal tears have healed. Laplace's law
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