2018 Volume 27 Issue 2 Pages 141-144
Background: We present a patient with symptomatic aortic coarctation who underwent stent graft insertion. Case: A 70-year-old woman with no medical history had been complaining of a sensation of chest compression for several days. Enhanced computed tomography (CT) revealed an untreated descending thoracic aortic coarctation. Antihypertensive medication was administered but was later discontinued owing to loss of sensation in the lower limbs and general malaise. After consideration of the surgical treatment options, stent graft insertion was selected because of her advanced age. We surgically inserted a stent graft into the aortic coarctation site. Although there were no issues during advancement through the coarctation site, catching the top cap and passing it through during retrieval was challenging. The stent was passed through with its bottom fixed to the outer sheath. Immediately after dilation, the blood pressure difference between the upper and lower limbs remarkably decreased from 50 mmHg to 10 mmHg. The symptoms improved after surgery and she was discharged on postoperative day 8. An enhanced CT scan at the 5-month follow-up showed that the diameter at the coarctation site had further increased, and the ankle-brachial index improved to 1.02 on the right and 1.06 on the left. Conclusion: Aortic stent grafting was effective in adult patients with symptomatic aortic coarctation.
