Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report

Abstract Background Congenital focal abdominal aortic coarctation (CAAC) is a rare vascular malformation frequently misdiagnosed as mid-aortic syndrome (MAS). A significant challenge in managing CAAC, particularly in young individuals, is addressing the coarctation while accommodating ongoing vascul...

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Main Authors: Siping Peng, Tao Hu
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Journal of Cardiothoracic Surgery
Subjects:
Online Access:https://doi.org/10.1186/s13019-025-03499-3
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author Siping Peng
Tao Hu
author_facet Siping Peng
Tao Hu
author_sort Siping Peng
collection DOAJ
description Abstract Background Congenital focal abdominal aortic coarctation (CAAC) is a rare vascular malformation frequently misdiagnosed as mid-aortic syndrome (MAS). A significant challenge in managing CAAC, particularly in young individuals, is addressing the coarctation while accommodating ongoing vascular growth and development. This case highlights the value of multidisciplinary collaboration and imaging-guided stentless balloon angioplasty in preserving vascular growth potential. Case presentation A 14-year-old male presented with a two-year history of refractory hypertension (peak:190/110mmHg) and exertional dizziness. Thoracoabdominal computed tomography angiography (CTA) revealed a focal coarctation (minimum luminal diameter: 4.2 mm, representing 70% stenosis) extending from the celiac artery origin to the superior mesenteric artery origin, without significant collateralization. Digital subtraction angiography (DSA)-guided balloon angioplasty (10 × 40 mm) resulted in a significant reduction of the transcoarctation pressure gradient from 45mmHg to 8mmHg, achieving normotension (120/80mmHg). At six-month follow-up, a 161% increase in aortic luminal diameter (to 11 mm) was observed, accompanied by complete regression of left ventricular hypertrophy (LVH), as evidenced by a decrease in interventricular septal thickness from 12 mm to 9 mm. Conclusions Stentless balloon angioplasty is an effective strategy in treating CAAC in adolescents, achieving both immediate hemodynamic relief and facilitating growth-adaptive aortic remodeling. Comprehensive aortic imaging is crucial for the diagnosis and management of refractory hypertension in adolescents.
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spelling doaj-art-fa1b4271fba3413b8d96c4d5aab5bc992025-08-20T02:30:59ZengBMCJournal of Cardiothoracic Surgery1749-80902025-06-012011710.1186/s13019-025-03499-3Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case reportSiping Peng0Tao Hu1Department of Cardiology, Jiangxi Pingxiang People’s HospitalDepartment of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeAbstract Background Congenital focal abdominal aortic coarctation (CAAC) is a rare vascular malformation frequently misdiagnosed as mid-aortic syndrome (MAS). A significant challenge in managing CAAC, particularly in young individuals, is addressing the coarctation while accommodating ongoing vascular growth and development. This case highlights the value of multidisciplinary collaboration and imaging-guided stentless balloon angioplasty in preserving vascular growth potential. Case presentation A 14-year-old male presented with a two-year history of refractory hypertension (peak:190/110mmHg) and exertional dizziness. Thoracoabdominal computed tomography angiography (CTA) revealed a focal coarctation (minimum luminal diameter: 4.2 mm, representing 70% stenosis) extending from the celiac artery origin to the superior mesenteric artery origin, without significant collateralization. Digital subtraction angiography (DSA)-guided balloon angioplasty (10 × 40 mm) resulted in a significant reduction of the transcoarctation pressure gradient from 45mmHg to 8mmHg, achieving normotension (120/80mmHg). At six-month follow-up, a 161% increase in aortic luminal diameter (to 11 mm) was observed, accompanied by complete regression of left ventricular hypertrophy (LVH), as evidenced by a decrease in interventricular septal thickness from 12 mm to 9 mm. Conclusions Stentless balloon angioplasty is an effective strategy in treating CAAC in adolescents, achieving both immediate hemodynamic relief and facilitating growth-adaptive aortic remodeling. Comprehensive aortic imaging is crucial for the diagnosis and management of refractory hypertension in adolescents.https://doi.org/10.1186/s13019-025-03499-3Congenital abdominal aortic coarctationAdolescent refractory hypertensionBalloon angioplastyVascular remodeling
spellingShingle Siping Peng
Tao Hu
Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report
Journal of Cardiothoracic Surgery
Congenital abdominal aortic coarctation
Adolescent refractory hypertension
Balloon angioplasty
Vascular remodeling
title Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report
title_full Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report
title_fullStr Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report
title_full_unstemmed Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report
title_short Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report
title_sort stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation a case report
topic Congenital abdominal aortic coarctation
Adolescent refractory hypertension
Balloon angioplasty
Vascular remodeling
url https://doi.org/10.1186/s13019-025-03499-3
work_keys_str_mv AT sipingpeng stentlessballoonangioplastypreservinggrowthinadolescentcongenitalfocalabdominalaorticcoarctationacasereport
AT taohu stentlessballoonangioplastypreservinggrowthinadolescentcongenitalfocalabdominalaorticcoarctationacasereport