Endovascular treatment of acquired atheromatous aortic arch coarctation

Abstract

Acquired aortic coarctation is a rare condition. Its treatment using a percutaneous approach can be challenging, especially when severe calcifications and concomitant aneurysmal disease are present. We report a patient with symptomatic thoracic aorta acquired coarctation and aneurysm that was successfully treated using endovascular technique. After left subclavian artery transposition, a self-expanding endograft was implanted percutaneously, with complete abolishment of the transaortic gradient. Follow-up evaluation at 12 months revealed perfect position of the endograft, persistent reduction of the coarctation, and exclusion of the concomitant aneurysm. A noninvasive pressure reading demonstrated significant systemic blood pressure reduction, with no change in antihypertensive medications.

Endovascular Treatment of Acquired Atheromatous Postsubclavian Aortic Coarctation

“…3 An acquired atheromatous coarctation can result when protruding calcified masses occlude the postsubclavian aorta. 6,7 The heavily calcified obstructive plaques characteristic of coral reef aorta can lead to hypertension, renal hypoperfusion, claudication, and heart failure. Their pathogenesis has been attributed by some to calcification of a fibrin-platelet thrombus, but atherosclerotic risk factors do not sufficiently explain the extensive calcification and metaplastic bone formation.…”

“…4,5 Calcification of the postsubclavian aorta can lead to acquired atheromatous coarctation. 6,7 We present the case of a young man with an acquired atheromatous coarctation of the postsubclavian aorta.…”