Coarctation of the abdominal aorta. Treatment by stent placement

We report a nine-year-old boy referred for evaluation of suspected coarctat ion of the aorta. He presented with hypertension and absent femoral pulses. A 50 mmHg gradient was detected in the abdominal aorta by color flow doppl er echocardiography but the level of coarctation was impossible to locate. The diagnosis was made by magnetic resonance imaging and aortography, showi ng segmentary hypoplasia in the upper abdominal segment of the descending a orta, immediately below the celiac axis and above the renal arteries. Treatment consisted in placement of a stent Palmaz, which was effective in significantly decreasing the gradient. Some clinical aspects and different therapeutic strategies for this unusual case are discussed.