Stenting of Significant Aortic Coarctation Near Artery of Adamkiewicz in a Toddler

Abdominal coarctation of the aorta is rare, and it poses unique procedural challenges when located near the artery of Adamkiewicz.

We describe a 4-year-old female patient who was found to have an abdominal coarctation of the aorta at the level of the diaphragm. Despite normal growth and minimal symptoms, the patient had significant upper-to-lower extremity blood pressure gradients and developed hypertension. The child underwent successful stent placement, achieving marked improvement in aortic diameter and pressure gradient without complications.

Few pediatric cases of distal aortic coarctation have been reported, and many involve congenital disorders such as Williams syndrome. Significant controversy remains regarding open surgical vs percutaneous stent approaches, especially in children with anatomical complexities.

Abdominal coarctation near the artery of Adamkiewicz is extremely uncommon. Careful preprocedural imaging and multidisciplinary planning can enable safe stent implantation, though follow-up is necessary to monitor for restenosis and vessel growth.