Abstract:
RATIONALE:Isolated dismal transverse aortic arch kinking in adults is rare, and there is no recommended therapy at present. Percutaneous stent implantation may be an effective method to correct it and could be considered. PATIENT CONCERNS:We report a 46-year-old woman who suffered from recurrent migraine and refractory hypertension with a significant systolic blood pressure difference between upper limbs. DIAGNOSES:The woman was diagnosed with isolated dismal transverse aortic arch kinking with refractory hypertension. INTERVENTIONS:Percutaneous stent implantation was performed. Due to the kinking nature of the diseased transverse aortic arch, the first covered stent moved forward to the proximal transverse aortic arch during deploying without the left common carotid artery occlusion. And then, a second stent was placed to cover the residual kinked part of the dismal transverse arch. OUTCOMES:Angiography and post-procedural computed tomography angiography revealed fully corrected of the diseased segment. At 6-month follow-up after procedure, the patient was free of any symptoms and had a normal blood pressure under antihypertensive treatment. LESSONS:This case indicates that transverse aortic arch kinking in isolation can be well treated by percutaneous stent implantation in adult patients. Unlike pure aortic coarctation, elongation and bucking give the rise to the occurrence rate of stent sliding and migration and sometimes a second stent is needed.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Zuo ZL,Tsauo JY,Chen M,Feng Ydoi
10.1097/MD.0000000000006089subject
Has Abstractpub_date
2017-03-01 00:00:00pages
e6089issue
10eissn
0025-7974issn
1536-5964pii
00005792-201703100-00008journal_volume
96pub_type
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