Balloon aortic angioplasty
Since the initial report of balloon angioplasty of aortic coarctation by Lababidi in 1983,1 treatment of this condition has evolved from a strictly surgical procedure to having multiple transcatheter-based options. As the techniques of balloon aortic angioplasty have matured, understanding of the potential as well as the pitfalls specific to balloon dilation of the aorta has also improved. Efficacy of balloon angioplasty of aortic coarctation
depends on many factors, including age at the time of initial intervention, whether the coarctation is native or postsurgical, and whether the coarctation is discrete or long segment/tubular. In addition, the location of the coarctation may also affect the results of balloon angioplasty. Coarctation may exist at many levels including the ascending, transverse, juxtaductal, early descending, as well as abdominal aorta. It is generally accepted that supravalvar aortic stenosis present inWilliam’s syndrome is not amenable to balloon angioplasty. While coarctation of the aorta is most commonly associated with a primary congenital process, secondary systemic diseases, such as fibromuscular dysplasia, Takayasu’s arteritis, and other ‘middle aortic syndromes’ can also result in hemodynamically significant narrowing of the aorta.