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Endovascular treatment of acquired atheromatous aortic arch coarctation

Stephan Kische1,2, Giuseppe D'Ancona1,2, Jasmin Ortak1,2

  • 1Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany.

Journal of Vascular Surgery Cases
|November 15, 2019
PubMed

Insights

Acquired aortic coarctation, a rare condition, poses treatment challenges. This study successfully used an endovascular technique to treat a patient with thoracic aorta coarctation and aneurysm, significantly reducing blood pressure.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Acquired aortic coarctation is a rare condition.
  • Treatment can be complex, particularly with severe calcifications and aneurysms.
  • Endovascular repair offers a minimally invasive option.

Purpose of the Study:

  • To report a successful endovascular treatment of acquired thoracic aortic coarctation with aneurysm.
  • To demonstrate the feasibility and efficacy of percutaneous repair in complex cases.

Main Methods:

  • A patient with symptomatic acquired thoracic aortic coarctation and aneurysm underwent left subclavian artery transposition.
  • A self-expanding endograft was implanted percutaneously to treat the coarctation and aneurysm.
  • Follow-up included imaging and noninvasive pressure measurements.

Main Results:

  • Successful complete abolishment of the transaortic gradient.
  • The endograft remained in perfect position at 12-month follow-up.
  • Persistent reduction of coarctation and exclusion of the aneurysm were observed.
  • Significant reduction in systemic blood pressure was achieved without medication changes.

Conclusions:

  • Endovascular repair is a viable and effective treatment for complex acquired aortic coarctation with aneurysm.
  • This approach can lead to significant clinical improvement, including blood pressure control.
  • Further research may explore this technique in similar complex cases.

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