Related Experiment Video
Updated: Apr 15, 2026
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Percutaneous treatment for aneurysmal coarctation of the aorta with covered stenting: a case report
Seyfollah Abdi1, Hoseinali Basiri1, Negar Salehi1
1Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Insights
Coarctation of the aorta (CoA) in adults, especially with aneurysms, is complex. Covered stent implantation proved safe and effective for treating a young adult male with resistant hypertension caused by CoA and an associated aneurysm.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Coarctation of the aorta (CoA) is a rare congenital heart defect that can present in adulthood, often leading to resistant hypertension.
- Adult CoA, particularly when associated with aneurysms, poses significant diagnostic and therapeutic challenges.
- Covered stents are a recommended treatment option for complex CoA cases, including those with aneurysms, older age, or severe narrowing.
Observation:
- A 26-year-old male presented with resistant hypertension secondary to a long coarctation of the aorta (CoA) with a large associated aneurysm.
- Computed tomography angiography and cardiac catheterization confirmed the diagnosis and revealed a significant pressure gradient across the CoA.
- Two balloon-expandable covered Cheatham-Platinum stents were successfully implanted, completely resolving the pressure gradient.
Findings:
- The covered stent implantation procedure was technically successful, with no residual gradient post-intervention.
- At a 2-year follow-up, the patient remained asymptomatic except for mild hypertension, indicating a favorable outcome.
- The use of a covered stent in the presence of an aortic aneurysm was demonstrated to be safe and effective.
Implications:
- This case highlights the successful management of complex adult coarctation of the aorta with an aneurysm using covered stent technology.
- Covered stents offer a viable and effective treatment strategy for selected adult patients with challenging CoA presentations.
- Further research into long-term outcomes and expanded use of covered stents in adult CoA is warranted.
Abstract:
The coarctation of the aorta (CoA) is rare in adulthood. Diagnosis is made by clinical suspicion and physical findings such as blood pressure difference between the upper and lower extremities, pulse delay in the femoral artery, and systolic murmur over the thoracic spine. The CoA in adulthood and in patients with associated aneurysm is challenging and different complications even with proper treatment can occur. Covered stents are indicated in concomitant aneurysm, older age, and tight coarctation. A 26-year-old male with resistant hypertension due to a CoA diagnosed by computed tomography angiography referred to our center for an attempted stent implantation. Cardiac catheterization and aortography revealed a long CoA after the origin of the left subclavian artery with a 60 mmHg gradient. Moreover, there was a large aneurysm in the site of the coarctation. Under general anesthesia and fluoroscopic guidance, two balloon-expandable covered Cheatham-Platinum stents (size 18 in 44 millimeters and size 18 in 50 millimeters) were successfully implanted across the CoA with no residual gradient. On 2 years' follow-up, the patient had no symptoms except for mild hypertension. In this patient, the use of a covered stent within the aneurysm was safe and effective.
