Transcatheter Endovascular Management of Complex Coarctation of the Aorta in Adults.

Coarctation of aorta (CoA) in adults is often diagnosed incidentally during the work-up for secondary or resistant hypertension causes, making it one of the treatable causes of hypertension. Treatment options range from surgery to transcatheter interventions. We present 2 cases of complex coarctation anatomy managed successfully with a transcatheter approach, facilitated by meticulous planning using advanced imaging techniques. The first case had long-segment CoA, which required deployment of a custom-made 120-mm-long Cheatham platinum stent. The second case had coarctation associated with a hypoplastic arch and left subclavian ostial stenosis, which was managed with a combination of covered and uncovered stent. Both patients showed good postprocedural outcomes, which were confirmed by means of 3-month follow-up computed tomography demonstrating well expanded stents, no endoleak, complete exclusion of aneurysms, and well perfused great vessels.