Dual Arterial Access for Stenting of Aortic Coarctation in Patients with Near-Total Descending Aortic Interruption

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Vascular Surgery

Background:

• Endovascular stenting is a standard treatment for adult coarctation of the aorta (COA).
• The typical retrograde femoral approach may be challenging in complex COA cases with aortic interruption.
• Alternative strategies are needed for successful intervention in such anatomies.

Purpose of the Study:

• To describe a modified endovascular stenting technique for severe COA with near-total descending aortic interruption.
• To evaluate the feasibility and safety of a combined radial/brachial and femoral approach in these complex cases.

Main Methods:

• Retrospective case series of three adult patients with severe COA and descending aortic interruption.
• Utilized a combined antegrade (radial/brachial) and retrograde (femoral) access for guidewire crossing and stent deployment.
• Successful stenting of the coarctation segment was achieved in all patients.

Main Results:

• The combined approach successfully treated severe COA in all three patients.
• No procedural complications were reported during the interventions.
• Patients remained free of adverse events at 6 months of follow-up, indicating good short-term outcomes.

Conclusions:

• A combined radial/brachial and femoral endovascular approach is a feasible and safe alternative for treating severe COA with descending aortic interruption.
• This technique overcomes limitations of the standard retrograde femoral approach in complex aortic anatomies.
• Further studies are warranted to confirm long-term efficacy.