Angioplasty and stenting of solitary supra-aortic artery and aortoplasty by kissing balloon technique

A child presented with symptoms of compromise to cerebral blood flow and ca rdiac failure. On diagnostic angiography, he was found to have a discrete c oarctation and related ostial stenosis of the left subclavian artery, which acted as the sole source of cerebral blood flow. The subclavian lesion was initially dilated with a 6 mm x 50 mm balloon. The discrete coarctation wa s then dilated with an 8 mm x 50 mm balloon. Since significant residual ste nosis was present at the subclavian origin, it was stented with a 20 mm Pal maz-Schatz stent (Cordis Corporation, Miami Lakes, Florida). Since the coar cted segment required further dilatations, the kissing balloon technique wa s used, wherein the 6 mm balloon was placed extending from the left subclav ian lesion distally to the related aortic lesion proximally along with anot her 10 mm balloon in the aorta. The end result was acceptable and the patie nt's symptoms improved significantly after the procedure.