Endovascular Management of Aortic Coarctation: Procedural Success, Blood Pressure Response, and Mid-Term Outcomes

doi:N/A

Bangaldesh Journal of Cardivascular Medicine

2025, Volume 3, Issue 4 : 1-6

Research Article

Endovascular Management of Aortic Coarctation: Procedural Success, Blood Pressure Response, and Mid-Term Outcomes

Farhan Ahmed

Nusrat Jahan

Mahmud Karim

Samira Rahman

⁴

Kamal Uddin

⁵

Department of Interventional Cardiology, National Heart Institute, Dhaka, Bangladesh

Department of Pediatric Cardiology, Bangladesh Medical University, Dhaka, Bangladesh

Department of Cardiovascular Surgery, Chattogram Medical College, Bangladesh

⁴

Department of Radiology and Cardiovascular Imaging, South Asia Medical Institute, Dhaka, Bangladesh

⁵

Department of Cardiovascular Research, Eastern Heart Centre, Dhaka, Bangladesh

Abstract

Background: Aortic coarctation is a congenital narrowing of the thoracic aorta that may present with upper-limb hypertension, lower-limb hypoperfusion, heart failure, or late vascular complications. Endovascular therapy has become an important treatment option, especially in adolescents and adults.

Objective: To evaluate procedural success, blood pressure improvement, complications, and mid-term outcomes after balloon angioplasty and stent implantation for aortic coarctation.

Methods: A prospective observational study was conducted among 96 patients with native or recurrent aortic coarctation treated endovascularly between January 2021 and December 2024. Clinical, imaging, procedural, and follow-up data were analyzed.

Results: Mean age was 19.8±8.7 years. Native coarctation was present in 72.9% and recoarctation in 27.1%. Stent implantation was performed in 78.1%, while balloon angioplasty alone was used in 21.9%. Technical success was achieved in 97.9%. Mean peak systolic gradient decreased from 48.6±15.4 mmHg to 8.7±5.6 mmHg. At 12 months, systolic blood pressure decreased from 156.8±18.9 mmHg to 128.4±12.7 mmHg. Major complications occurred in 4.2%.

Conclusion: Endovascular management of aortic coarctation is safe and effective, with high procedural success, marked gradient reduction, improved blood pressure control, and acceptable complication rates. Stent implantation is preferred in adolescents and adults with suitable anatomy.

Keywords

Aortic coarctation

Endovascular therapy

Balloon angioplasty

Stent implantation

Hypertension

Congenital heart disease

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