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4 . 2025

Long-term results of endovascular treatment of middle aortic syndrome in a child (clinical case)

Abstract

Mid-aortic syndrome is a condition characterized by obstructive lesions of the thoracoabdominal aorta, occurring in approximately 0.5–2% of cases. This report presents the long-term outcomes of a clinical case involving transcatheter treatment of mid-aortic syndrome in a child. At an early age, the patient underwent recanalization of an occluded thoracoabdominal segment, followed by staged balloon angioplasty and implantation of an Advanta V12 OTW 9×59 mm stent-graft (Getinge Group, Sweden). After the initial procedure, the patient was followed up over a 3-year period. During a routine hospitalization, an increase in the peak pressure gradient between the upper and lower extremities up to 30 mmHg was noted, along with a stenosis of the mid-portion of the stent-graft to 3.3 mm in diameter. Due to the evolving clinical presentation, a decision was made to perform repeat endovascular intervention. A Visi-Pro stent (Medtronic Corp., USA), 9×17 mm in size was implanted at the site of maximum stenosis followed by sequential balloon angioplasty. Control angiography revealed moderate residual stenosis with a luminal diameter of 7.5 mm and a peak gradient of 10 mmHg. Antiplatelet therapy (acetylsalicylic acid) and antihypertensive therapy (enalapril) were prescribed. The patient was discharged in satisfactory condition on postoperative day 5.

Transcatheter techniques do not always achieve complete elimination of the stenotic area and require close follow-up due to the risk of neointimal hyperplasia. Nevertheless, the endovascular approach to palliative correction of mid-aortic syndrome allows the child to reach an optimal age for definitive surgical repair while reducing the need for repeated open procedures.

Keywords: mid-aortic syndrome; thoracoabdominal; transcatheter; occlusion; stent-graft

Funding. The study was not supported by sponsorship.

Conflict of interest. The authors declare no conflicts of interest

Authors’ contribution. Study conception and design – Gorbatykh A.V., Kuznetsova P.A., Rzaeva K.A.; data collection and handling – Soynov I.A., Prokhorikhin A.A.; draft manuscript preparation – Kuznetsova P.A.; manuscript revision – Gorbatykh A.V., Rzaeva K.A., Chernyavskiy M.A., Alekseeva D.A.

For citation: Kuznetsova P.A., Rzaeva K.A., Soynov I.A., Prokhorikhin A.A., Alekseeva D.A., Chernyavskiy M.A., Gorbatykh A.V. Long-term results of endovascular treatment of middle aortic syndrome in a child (clinical case). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (4): 137–43. DOI: https://doi.org/10.33029/1027-6661-2025-31-4-137-143

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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