Two-stage endovascular treatment of a patient with hemodynamic interrupted aortic arch in segment A and bicuspid aortic valve

Author(s): Kostiantyn Boyko, Andriy Khokhlov, Dmytro Loskutov, Borys Todurov

This clinical case represents an experience of two-stage endovascular repair of Complete Interrupted Aortic Arch (CIAA) in segment A in a 21-year-old patient.

Upon admission to clinic, the patient was diagnosed with CIAA and bicuspid aortic valve. Aortography showed CIAA distally from the origin of the left subclavian artery. At the first stage of treatment, CIAA on-site perforation was performed followed by PTFE (polytetrafluoroethylene)-coated CP STENT 45 mm system implantation using BIB (Balloon-in-Balloon) catheter.

The second intervention stage was performed 10 months after the first stage using balloon dilatation of stented segment with AndraBalloon 12.0 mm × 20.0 mm and 14.0 × 40.0 mm.

The residual maximum pressure gradient in descending aorta after our treatment was 10 mm Hg.

Three years after the treatment the patient has no symptoms of CIAA or coarctation, the patient does not take any antihypertensive drugs, and the pressure on the upper limbs is 125/85 mm Hg.