From stent to stability: Conservative management of post-stenting aortic dissection in coarctation of the aorta

Coarctation of the aorta (CoA) is characterized by congenital narrowing of the aortic isthmus. Primary treatment modalities include balloon dilatation, stenting, and surgical repair. Here, we present the case of a 37-year-old male with refractory hypertension who underwent successful stenting of a severe postductal CoA, achieving complete resolution of the trans-coarctation gradient. Twenty-four hours later, he developed severe inter-scapular pain, and computed tomography aortography revealed an extensive Stanford type B aortic dissection extending from the distal stent margin to beyond the aortic bifurcation. As there were no signs of end-organ malperfusion, conservative management was pursued with close monitoring and blood pressure control. The dissection stabilized and the patient responded favorably, with sustained stability on the follow-up.