[Atypical aortic coarctation in adult patients undergoing percutaneous stent implantation].

“Atypical” aortic coarctation (AAC) is a rare clinical entity that includes involvement of the ascending thoracic aorta, the descending thoracic aorta distal to the aortic isthmus, and the abdominal aorta. Abdominal aortic coarctation is present in 1% to 2% of all patients with aortic coarctation and is an unusual cause of essential hypertension in adults. AAC is caused by focal stenosis or a hypoplastic segment of the aorta, is most often found at the renal level, and is frequently related to stenosis of the renal arteries (60%) or mesenteric arteries (30%).1 AAC has several causes, both congenital and acquired, although the latter are more common. Among the potential causes of acquired origin, the most common is Takayasu arteritis.2 The typical clinical presentation in young patients is hypertension in the upper limbs and a decrease or lack of pulses in the legs.1 In addition to the clinical history, the diagnosis is supported by noninvasive imaging tests, such as contrast-enhanced computed tomography (CT angiography), magnetic resonance imaging, and transesophageal echocardiography.3 Catheterization, the definitive diagnostic method, demonstrates the arterial pressure gradient across the stenosis. We describe a 28-year-old man who underwent study for essential hypertension. The examination showed normal physical development, blood pressure in the arms of 165/97 mm Hg, decreased pulses in the legs, and a systolic bruit, localized to the epigastrium. Transthoracic echocardiography revealed preserved ventricular function with mild left ventricular hypertrophy, but no other valvular or descending thoracic aorta abnormalities. CT angiography, performed to assess the