A rare cause of severe aortic coarctation in an adolescent: coral reef aorta

Abstract

Coral reef aorta (CRA) is a rare, calcified aortic lesion observed primarily in adults and elderly patients. This condition can lead to resistant hypertension and impaired organ perfusion. Although surgical treatment remains the predominant approach, endovascular intervention is emerging as an alternative for suitable cases. We present a 16-year-old male patient with a history of kidney transplantation who was admitted due to hypertension. Imaging revealed severe stenosis at the isthmus level caused by a calcific lesion characteristic of CRA. Given the complexity of the lesion and the surgical challenges, an endovascular approach was chosen. A covered stent was successfully implanted, resulting in significant hemodynamic improvement. At the sixth month follow-up, the patient remained normotensive, and antihypertensive medications were discontinued. To our knowledge, this case represents the first pediatric patient reported to have undergone endovascular treatment for severe aortic coarctation associated with CRA. Our findings suggest that endovascular intervention using a covered stent may provide a viable alternative to surgery in selected pediatric cases, minimizing morbidity and mortality. Further studies are needed to assess the long-term outcomes of this approach.