Endovascular treatment of acquired atheromatous aortic arch coarctation

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.