Coarctation of the aorta (CoA) constitutes 5–8% of all congenital heart defects and impacts approximately 0.07% of the general population.1 Recent advances in the timely diagnosis and treatment of CoA in infancy and early childhood have resulted in the survival of the vast majority of patients into adulthood. However, a wide array of literature suggests that despite being treated for aortic stenosis, patients with CoA are still at a significantly higher risk of cardiovascular morbidity and mortality, with nearly 70% of them dying from cardiovascular events.2,3 The spectrum of cardiovascular complications associated with CoA is broad, encompassing arrhythmias, aortic aneurysms/pseudoaneurysms, accelerated coronary artery disease, heart failure, and strokes resulting from persistent and late-onset hypertension. These complexities underline the need for extended, vigilant follow-up and emphasize the imperative for enhanced treatment strategies.2, 3, 4, 5

In recent decades, the primary approach for treating CoA has transitioned from surgery to endovascular therapies, such as balloon angioplasty and stent implantation, especially beyond the neonatal and infantile period.6 Given its superior immediate effectiveness and lower complication rates compared with balloon angioplasty, stent implantation is currently considered the standard of care in adolescents and adults with aortic coarctation.7 Furthermore, the evolving data on innovative stent designs and the application of newer stents in neonates and younger children with Coarctation of the Aorta have broadened the scope and effectiveness of stent-based interventions.8, 9, 10 However, the limited patient population in such studies poses a challenge to reaching a consensus on the safety and efficacy of stenting in younger children. There is a growing literature on stent implantation for CoA treatment with promising acute success rates and low rate of short-term complications, including stent fracture and migration as well as the need for reintervention.7,11,12 However, some recent large cohorts on the late outcomes of stenting reported an increased incidence of such adverse events and a higher rate of reintervention in long-term follow-up, which may buffer against the putative safety and effectiveness of this treatment modality.6,13 Hence, given the scarcity of recent systematically gathered data, definitive conclusions are not attainable. The present comprehensive meta-analysis, encompassing all published studies, aims to provide a detailed review of the acute, intermediate, and long-term outcomes, as well as complications associated with endovascular stent placement for the treatment of both native and recurrent aortic coarctation.