Endovascular treatment of aortic coarctation: long-term effects on hypertension

Int J Cardiol. 2008 Nov 28;130(3):420-5. doi: 10.1016/j.ijcard.2007.08.130. Epub 2007 Dec 31.


Introduction: Endovascular management of aortic coarctation (CoA) is safe but few data are available concerning the long-term cure of hypertension. Aim of this study was to evaluate immediate and long-term clinical and haemodynamic outcome in a consecutive series of adolescent and adult patients with CoA submitted to endovascular treatment.

Methods: A total of 21 adolescent and adult patients underwent successful transcatheter intervention of CoA. Follow-up comprised cardiological examination with special attention to blood pressure (BP), echocardiogram, 24/h ambulatory blood pressure monitoring (ABP), exercise test and spiral computed tomography.

Results: Pre-intervention CoA diameter and degree of stenosis were 4.8+/-2.1 mm and 73.7+/-9.8%, respectively, and 14.8+/-3.0 mm and 13.5+/-6.5% post-intervention (p<0.001). Systolic arterial hypertension persisted in 2 patients at rest (9.5%). Mean number of antihypertensive medications per patient was 1.5+/-1.1 and 0.5+/-0.9 at 1 year after treatment (p<0.05). At ABP 3 patients (14%) were hypertensive. The Doppler gradient across the coarctation site decreased from 58.8+/-16.9 to 10.5+/-4.9 mmHg (p<0.001) as well as left ventricular mass (199+/-14.6 and 189.3+/-9.1; p<0.001). Overall, 18 patients (86%) underwent a treadmill exercise test and 4 patients (22%), normotensive at rest, showed a pathological blood pressure response. Overall, 7/21 patients (33%) showed persistent hypertension.

Conclusion: Endovascular treatment of native or recurrent CoA in adolescent and adult patients is safe but 33% of patients showed persistent hypertension. Meticulous clinical follow-up is mandatory, including an exercise test in order to monitor eventual blood pressure increase and to assess effort tolerance.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angioplasty, Balloon*
  • Antihypertensive Agents / therapeutic use
  • Aortic Coarctation / complications
  • Aortic Coarctation / diagnostic imaging
  • Aortic Coarctation / therapy*
  • Blood Pressure
  • Child
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy
  • Hypertension / therapy*
  • Male
  • Middle Aged
  • Stents*
  • Tomography, Spiral Computed
  • Treatment Outcome
  • Young Adult


  • Antihypertensive Agents