key: cord-0012215-gmxolsh9
authors: Freund, M. W.; Vollebregt, A. M.; Krings, G.; Vonken, E. P. A.; Agostoni, P.; Meijboom, F. J.
title: Native atretic coarctation of the aorta in a 37-year-old hypertensive woman, treated with a low-profile covered stent
date: 2013-04-01
journal: Neth Heart J
DOI: 10.1007/s12471-011-0156-7
sha: 2ccd8ae603751b1a10d34542d86b32f0f55f113a
doc_id: 12215
cord_uid: gmxolsh9

nan

We report on a 37-year-old woman with essential systemic hypertension. An MRI was performed because of weak femoral pulses, depicting a severe almost atretic coarctation of the aorta (Fig. 1) . Angiography of the proximal distal thoracic aorta was simultaneously performed (Fig. 2a) . The transverse arch was narrow (16 mm), as was the diameter of the terminal aortic arch distal to the left subclavian artery (10 mm). Distal of the coarctation the diameter of the descending aorta was 11 mm. A trajectory of 2 mm in length seemed atretic. The atretic segment could be crossed in an antegrade fashion with a straight 0,014 in. coronary wire and balloon predilatation was performed with a 5 mm coronary balloon. Thereafter, a multi-purpose catheter could be advanced retrogradely across the coarctation segment. A 9 French Mullins sheath (Cook) was advanced to the transverse aortic arch. A 41 mm long Advanta V12 premounted covered stent (Atrium, Hudson, USA) on a 12 mm high pressure balloon was implanted. Consecutive angiography revealed complete expansion of the stent up to 12 mm without residual stenosis, and no aneurysm formation (Fig. 2b) .

In conclusion, treatment with placement of a lowprofile covered stent, using a simultaneous radial and femoral approach and pre-dilatation, delivered an excellent result without complications and a short hospital stay. The patient's blood pressure returned to normal and her antihypertensive medication could be stopped within 3 weeks after stent implantation. We emphasise that in so-called 'unexplained' systemic hypertension, especially in young adults, coarctation of the aorta has to be excluded [1, 2] . When coarctation is confirmed primary stenting is the first choice therapeutic option [3] [4] [5] .

Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. 

Early diagnosis of coarctation of the aorta in children: a continuing dilemma

Long-term outcome after balloon angioplasty of coarctation of the aorta in adolescents and adults: is aneurysm formation an issue?

Endovascular stents in the management of coarctation of the aorta in the adolescent and adult: one year follow up

Coarctation of the aorta treated with the Advanta V12 large diameter stent: acute results

Endovascular stenting for aortic (re)coarctation in adults