Coarctation of Aorta Mimicking Aortic Arch Interruption and its Successful Dilatation by an Innovative Approach.

Balloon dilatation for coarctation of the aorta is an established alternative to surgery in older children and young adults with a high success rate and a low incidence of restenosis.1Ð4 However, balloon dilatation has to be performed with extreme caution when the coarct segment involves the major branches of the aortic arch or when the coarct has an atypical anatomy. Herein, we report an unusual case which was suggestive of aortic arch interruption on descending thoracic aortography and could not be crossed retrogradely. Brachial approach for ascending aortography revealed that this was indeed a coarct with a distorted anatomy and also made possible crossing of the coarct antegradely. After exteriorizing the guide wire across the coarct with the help of a snare device advanced through the femoral arterial sheath, the coarct could be dilated from the femoral route as is routinely done.