Endovascular Treatment of Acquired Atheromatous Postsubclavian Aortic Coarctation

Abstract

Coral reef aorta is a rare calcifying obstructive disease that involves the thoracoabdominal aorta. Similar presentations in the postsubclavian aorta may result in acquired atheromatous aortic coarctation leading to systemic hypertension and heart failure. The associated calcification makes surgical anatomic or extraanatomic bypass and thromboendarterectomy challenging. Extensive circumferential calcification often precludes endovascular intervention. We present the case of a 25-year-old man with an acquired atheromatous coarctation of the postsubclavian aorta who underwent successful endovascular treatment with use of a balloon-expandable covered stent.

Challenging Endovascular Treatment of Coral Reef Aorta and a Literature Review

“…4 However, there is general acceptance that the surgical open technique is associated with high rates of perioperative mortality (8.7-11.6%) and serious postoperative complications. 9,10 A newer alternative technique is stent-graft placement, especially in selected patients. 7 In the last decade, the endovascular method seems to make its appearance and is the protagonist in the treatment of selected patients with CRA who cannot be treated with the open method.…”

“…7 In the last decade, the endovascular method seems to make its appearance and is the protagonist in the treatment of selected patients with CRA who cannot be treated with the open method. According to the current literature and platforms, the terms “endovascular stent-graft therapy” and “coral reef aorta” coexist and appear since 2008, and since then, only 13 articles ( Table 1 ) 3 4 5 8 10 11 12 13 14 15 16 17 18 have been published, most of them in the past 3 years. This is probably because vascular surgeons' familiarity with the endovascular technique and the appearance of newer and more advanced endovascular tools encourage vascular surgeons to dare to use the method.…”

“…4 However, there is general acceptance that the surgical open technique is associated with high rates of perioperative mortality (8.7–11.6%) and serious postoperative complications. 9 10…”

“…Recorded cases of endovascular treatment with stent graft of coral reef aorta reported in bibliographic databases and platforms[3][4][5]8,[10][11][12][13][14][15][16][17][18] …”