Management of Severe Coarctation of the Aorta and Bilateral Carotid Artery Stenosis: An Interventional Catch-22

Alice N W Leung; Karan Rao; Jun Kim; Brendan Steinfort; Nikhil Vasan; David Tanous; Chi-Jen Hsu

doi:10.1016/j.jaccas.2022.101693

Management of Severe Coarctation of the Aorta and Bilateral Carotid Artery Stenosis: An Interventional Catch-22

JACC Case Rep. 2022 Dec 7:6:101693. doi: 10.1016/j.jaccas.2022.101693. eCollection 2023 Jan 18.

Authors

Alice N W Leung^{1

2}, Karan Rao^{1

3}, Jun Kim⁴, Brendan Steinfort⁵, Nikhil Vasan⁴, David Tanous¹, Chi-Jen Hsu^{1

2}

Affiliations

¹ Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia.
² Department of Cardiology, Blacktown Hospital, Sydney, New South Wales, Australia.
³ The University of Sydney, Sydney, New South Wales, Australia.
⁴ Department of Neurosurgery, Westmead Hospital, Sydney, New South Wales, Australia.
⁵ Department of Radiology, Westmead Hospital, Sydney, New South Wales, Australia.

Abstract

We present a case of an adult with concurrent severe aortic coarctation, bilateral carotid artery stenosis, and anomalous right subclavian artery, posing the interventional dilemma of accepting potential cerebral hyperperfusion syndrome vs hypoperfusion ischemic injury. Transcatheter stenting of the aortic coarctation was successfully performed without any neurological deficits. (Level of Difficulty: Beginner.).

Keywords: LV, left ventricular; SBP, systolic blood pressure; bilateral carotid stenosis; coarctation of the aorta; secondary hypertension; transcatheter interventions.

Publication types

Case Reports