Successful double-step percutaneous repair of aorticatresia

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Aortic atresia (n=1). Intervention: Percutaneous repair with covered stent (Bentley BeGraft). Primary outcome: Resolution of hypertension and pressure gradient.

Paulina Figarska; Robert Sabiniewicz; Anna Sabiniewicz

doi:10.5114/aic.2026.160011

January 1, 2026Advances in Interventional CardiologyOpen Access

Successful double-step percutaneous repair of aorticatresia

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Key Points

To evaluate the feasibility and safety of a double-step percutaneous endovascular repair in an adult patient presenting with aortic isthmic atresia and resistant arterial hypertension.
A 30-year-old female with persistent hypertension underwent diagnostic computed tomography angiography and invasive angiography confirming aortic isthmic atresia with collateral circulation.
Antegrade sharp guidewire puncture via right radial access was performed to cross the atretic segment, followed by balloon pre-dilation and retrograde implantation of a Bentley BeGraft 12 × 39 mm covered stent via the right femoral artery.
Percutaneous balloon re-dilatation of the stent was executed during 2-month follow-up after surveillance transesophageal echocardiography detected a peak systolic gradient.
Initial covered stent placement re-established continuity between the aortic arch and descending aorta, eliminating the direct trans-stent pressure gradient prior to hospital discharge on day 3.
At 2-month follow-up, the patient remained normotensive without antihypertensive medications despite an echocardiographic peak systolic gradient of 50 mm Hg.
Percutaneous re-dilatation successfully relieved the residual gradient with an excellent angiographic result.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

1 30-year-old female with resistant arterial hypertension, bicuspid aortic valve with mild insufficiency, dilatation of the aortic root, and aortic isthmic atresia with extensive collateral circulation.

I

Intervention

Percutaneous recanalization of aortic atresia and implantation of a covered stent (Bentley BeGraft 12 × 39 mm), followed by a second percutaneous re-dilatation of the stent at 2 months.

O

Outcome

Procedural success (no pressure gradient) and clinical resolution of hypertension.

Percutaneous repair of aortic atresia using a covered stent is a feasible and effective alternative to surgery in adult patients, leading to resolution of resistant hypertension.

Limitations

Requires adequate landing zones for stent
Risk of stent sliding if aorta is dilated proximally and distally
Covered stent can collide with the left subclavian artery
Stent needs adequate landing zones for its proximal and distal ends
Dilatation of aorta proximally and distally to the atretic segment poses a risk of stent sliding
Covered stent expanded in the isthmus can collide with the left subclavian artery

Implication

Supports percutaneous stenting feasibility in adult aortic atresia; leaves open prospective validation before practice change.

Abstract

A 30-year-old female with resistant arterial hypertension presented to the Department of Cardiology for clinical evaluation. Elevated blood pressure was first diagnosed 2 years before, during pregnancy and persisted after the delivery. On physical examination, she presented with diastolic murmur over the right sternal border. Transthoracic echocardiography revealed bicuspid aortic valve with mild insufficiency and dilatation of the aortic root. Computed tomography angiography (CTA) was performed for complete assessment of the aneurysm and revealed aortic isthmic atresia with extensive collateral circulation (Figure 1 A). The patient was qualified for percutaneous repair. Using an ante grade approach (right radial access) a pigtail catheter was introduced to the aortic arch (AA). Aortic atresia was confirmed with angiography

Discussion

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Cite This Study

Figarska et al. (2026) conducted a case report in Aortic atresia (n=1). Percutaneous repair with covered stent (Bentley BeGraft) was evaluated on Resolution of hypertension and pressure gradient.

synapsesocial.com/papers/6a025e8a93868c48f3093dc7 https://doi.org/10.5114/aic.2026.160011

View Full Paper

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Successful double-step percutaneous repair of aorticatresia

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Successful double-step percutaneous repair of aorticatresia

Figures

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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Keep reading

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