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Stent Dilation of Aortic Coarctation


Contributor: Mohamed Hamdan, MD

Angiograms of descending thoracic coarctation

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Clinical comments:

Coarctation of the aorta is a discrete stenosis in the thoracic aorta, first described by Morgagni in 1760. Shown to the left are coarctations of descending aorta, and top of arch respectively. Coarcts have a wide spectrum of presentations from cardiogenic shock in the neonate, to murmur and upper limb hypertension in adults.

Balloon dilation was introduced in 1982 as an alternative to surgery. Since then, balloon-expandable endovascular stents have been used successfully to treat large vessel stenoses. Dilation angioplasty with a stent creates a controlled tear in the aortic wall supported by the stent framework, minimizing risk of dissection or aneurysm formation that could occur with balloon dilation alone.

Some clinicians consider stent placement to be treatment of choice for aortic coarctation (native or recurrent) in older children and adults. ...More...
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