Balloon Dilation Angioplasty Research Articles

Neuro-Interventional Diagnosis and Treatment Using the Right Transradial Approach in Patients with Aberrant Right Subclavian Artery

BackgroundAberrant right subclavian artery (ARSA) is a common anatomical variation that presents challenges in cerebral angiography and interventions through the transradial approach (TRA). ARSA is often identified during surgery using the right transradial approach (R-TRA), and this necessitates a change in the approach. ObjectiveTo assess the effectiveness and safety of neurological interventions using R-TRA in patients with ARSA. MethodsWe retrospectively analyzed cases that underwent cerebral angiography and interventions at Huangpi District People’s hospital from January 2023 to July 2023. Out of 335 cases, five patients with ARSA were identified. ResultsAll five cases underwent diagnostic cerebral angiography via R-TRA. Two of the patients received interventions via R-TRA: one underwent right internal carotid artery balloon dilation angioplasty, while another underwent left vertebral artery stenting. No surgery-related complications were observed during these procedures. ConclusionsR-TRA proves to be a safe and effective option for neuro-interventional surgery in patients with ARSA.

A retrospective study of individualized endovascular treatment for symptomatic intracranial atherosclerotic stenosis in patients with ischemic stroke/transient ischemic attack.

Endovascular treatment (EVT) is one of the effective treatment procedure for the symptomatic intracranial atherosclerotic stenosis (sICAS). We evaluated the efficacy and safety of individualized endovascular treatment for sICAS patients. Clinical and imaging follow-ups were carried out to collect the data of 29 sICAS patients after 6 months of individualized endovascular treatment. Different treatment strategies are selected based on arterial access and lesion morphology of patients. If standard surgical path, narrow artery straight, stenosis length ≤10 mm, then the appropriate specifications of balloon-mounted stent (BMS) treatment. the surgical path is tortuous, the narrow artery is curved, the angle is apparent, the diameter of the near and far ends is significantly different, or the length of the stenosis is >10 mm, self-expanding stent (SES) with appropriate specifications is selected for treatment. If the narrowed artery is hyper flexed and the surgeon deems stenting inappropriate, balloon dilation angioplasty (BDA) treatment is chosen. 31 lesions of 29 sICAS patients received endovascular treatment. The median age was 61 years (IQR 54-69 years). The median preoperative stenosis was 90% (IQR 80-95%), and the mean stenosis length was (8.10 ± 3.27) mm. The most commonly used surgical procedure was Balloon-Mounted Stent (BMS) in 19 cases (65.52%), Self-expanding Stent (SES) in seven cases (24.14%), Balloon Dilation Angioplasty (BDA) in three cases (10.34%). (11.86 + 1.46 mm) was greater than that in the BMS group (6.14 + 1.59 mm) (P < 0.001). The median stenosis was 90% (IQR 80-92.5%) in the BMS group, lower than 99% (IQR 95-100%) in the SES group (P < 0.001). The median post-operative residual stenosis was 20% (IQR 15-25%), significantly improved compared with preoperative (P < 0.001). The success rate of the surgical technique was 93.10% (27/29). One patient (3.45%) had IS recurrence within 48 h after surgery, and the restenosis rate within 6 months after surgery was 6.90% (2/29). No patient died or had recurrent IS. Our data demonstrated that individualized endovascular treatment method could be potentially significant and safe for sICAS patients. This study will provide an important reference for the endovascular treatment of sICAD.

Application of the AngioJet Ultra Thrombectomy Device for the Percutaneous Mechanical Treatment (PMT) of Iliac Limb Occlusion after Endovascular Aneurysm Repair (EVAR)

To investigate the safety and efficacy of applying the AngioJet Ultra thrombectomy device in treating endograft occlusions in the iliac arteries following endovascular aneurysm repair (EVAR). This study utilized a retrospective analysis of 452 patients with infrarenal abdominal aortic aneurysm (AAA). Twelve of the patients experienced iliac limb occlusion during their follow-up period, and the AngioJet Ultra thrombectomy device was used in tandem with iliac angioplasty to treat these patients. The safety of the device was assessed through the amount of blood drawn, the duration of the procedure, and the occurrence of post-operative complications, while its efficacy was assessed through aortic computed tomography angiography (CTA) imaging and post-operative symptomatology results. All 12 patients were male, and they had a mean age of 62.8 ± 11.8 years. Iliac limb occlusion occurred on the left side of 4 patients and on the right side of 8 patients. The AngioJet Ultra thrombectomy device was used together with iliac angioplasty during surgery, with a success rate of 100%. A bifurcated endograft was successfully implanted in 9 patients following AngioJet Ultra thrombectomy and balloon dilation angioplasty, while a unibody endograft was successfully implanted in 3 patients following AngioJet Ultra thrombectomy and balloon dilation angioplasty. The mean surgery duration was 2.4 hrs, and the patients were hospitalized for an average of 4.5 days. After surgery, the patients' intermittent claudication/buttock claudication gradually vanished. Two patients experienced hemoglobinuria, with one of them developing mild renal dysfunction. Currently, the twelve patients have been followed up for an average of 12 months, and none have experienced any lower extremity ischemia. The use of the AngioJet Ultra thrombectomy device as a supplementary treatment for iliac limb occlusion following abdominal EVAR is safe, effective, and minimally invasive.

EVALUATION OF BALLOON ANGIOPLASTY IN INFRAPOPLITEAL INTERVENTIONS FOR PATIENTS WITH CRITICAL LIMB ISCHEMIA

Background: Peripheral arterial occlusive disease (PAOD) is a major disease that limits active aging in elderly people. Complications of PAOD are the leading cause of hospitalization and amputation for people with lower limb ischemia, and account for billion-dollar expenditures annually around the world. Objective: To assess the balloon dilation angioplasty in limb salvage rate and patency in infra-popliteal arterial occlusive disease. Patients and methods: This study was carried out as a prospective study, in Al-Azhar University Hospitals and 6 October HIO hospital on 20 diabetic patients with critical limb ischemia as defined by Rutherford classification, between Jan, 2019 and July, 2019. Written consents were obtained from all patients. Every patient received an explanation to the purpose of the study. Results: The present study was conducted on 20 diabetic patients, 11 males (55%) and 9 females (45%).Their ages ranged between 50 years and 87 years with a mean age of 66.7. Limb salvage was defined as freedom from major amputation, toe, ray, or trans-metatarsal amputations were considered as minor amputations. The limb salvage after 6 months was 70%, clinical successes were defined as relief of rest pain or improve healing of the ulcer and limb salvage, based on Rutherford categories. Of 3 patients (15 %) suffering from rest pain, Percutaneous Transluminal Angioplasty (PTA) succeeded in 2 patients (66.7%) and became non-disabling cludicants at more than 400m. PTA failed in one patient (33.3%), who underwent redo angioplasty, but failed again. He received conservative treatment in the form of anticoagulants, antiplatelets and vasodilators without improvement and ended by major amputation. Of 17 patients (85 %) suffering from minor tissue loss, PTA succeeded in 11 patients (64.7%) improve healing was achieved, PTA failed in 6 patients (35.3%) four patients underwent femoro-distal bypass surgery, but failed and diabetic foot infection with osteomyelitis reached up to ankle joint and ended by major amputation. Two patients underwent above knee amputation before six months. Two patients underwent below knee amputation at six months. The other 2 patients underwent above knee amputation before six months due their deterioration of their general condition. Conclusion: Tibial angioplasty demonstrated its feasibility, safety and effectiveness in the treatment of diabetic patients with CLI.

Vaping Induced Pathological Changes in the Lung: A Case Report Study

Introduction: The angiosome concept was first described in 1987, defining an angiosome as an area of tissue comprising skin, subcutaneous tissue, fascia, muscle and bone supplied by a specific artery and drained by a specific vein. We report a case of a patient who was successfully complex revascularized by open surgery and endovascular techniques based on angiosome concept. Case presentation: A 73-years-old male patient with critical limb ischemia and type 2 diabetes, presented increasing resting pain in the lower right limb during the last 3 months, followed by necrosis of distal phalanx of I and II toes, wet interdigital necrosis of toes I-II on the right leg, with absence of distal pulses on both limbs. Direct flow into affected angiosome was successfully achieved with right proximal femoral-popliteal saphenous vein bypass and ATA balloon dilatation angioplasty. Conclusion: The vascular patient with critical ischemia associated to diabetes currently requires a complex treatment including open surgery, endovascular technique and negative pressure therapy to save the lower limbs. The angiosome concept is useful during both open and endovascular tibial revascularisation.

Complex Lower Limb Revascularization Based on Angiosomes Concept: A Case Report

Introduction: The angiosome concept was first described in 1987, defining an angiosome as an area of tissue comprising skin, subcutaneous tissue, fascia, muscle and bone supplied by a specific artery and drained by a specific vein. We report a case of a patient who was successfully complex revascularized by open surgery and endovascular techniques based on angiosome concept. Case presentation: A 73-years-old male patient with critical limb ischemia and type 2 diabetes, presented increasing resting pain in the lower right limb during the last 3 months, followed by necrosis of distal phalanx of I and II toes, wet interdigital necrosis of toes I-II on the right leg, with absence of distal pulses on both limbs. Direct flow into affected angiosome was successfully achieved with right proximal femoral-popliteal saphenous vein bypass and ATA balloon dilatation angioplasty. Conclusion: The vascular patient with critical ischemia associated to diabetes currently requires a complex treatment including open surgery, endovascular technique and negative pressure therapy to save the lower limbs. The angiosome concept is useful during both open and endovascular tibial revascularisation.

Brachio-Cubital Fasciotomy for Resistant Stenosis of Arterio-Venous Fistula

Purpose: Radio-cephalic arterio-venous fistula can become dysfunctional due to venous outflow stenosis along its course. When the median cubital and the upper arm cephalic vein are small or obliterated, all the forearm cephalic vein blood flow can go through the perforating deep median vein into the brachial vena comitans. These deeply located veins, when dilated, become compressed by the overlying antecubital fascia and bicipital aponeurosis. These ensuing stenoses are usually resistant to endovascular balloon dilatation angioplasty or recur rapidly afterwards. Brachio-cubital fasciotomy was utilized to help relieve the compression and salvage the access. Methods: For the confirmed resistant stenoses of the AVF, open fasciotomy was performed along the medial aspect of the antecubital fossa. Endovascular angioplasty of the stenotic lesions was accomplished in conjunction with vascular skeletonization while the balloon was inflated inside the AVF. Results: Nineteen patients recognized to have resistant stenoses of their AVF underwent brachio-cubital fasciotomy. Through the fasciotomy, stenoses were resolved and intra-access pressure reduced to satisfactory levels in all patients. Three patients required resection of the constricted segment and reanastomosis of the mobilized fistula in addition to the fasciotomy. At the follow-up observation of minimum 9 months, all but one of the rescued stenotic lesions stayed patent and required no further intervention. Conclusions: Radio-cephalic arterio-venous fistula can become dysfunctional due to the development of outflow stenosis from compression by overlying fascia and this stenosis is usually resistant to the dilatation angioplasty. Brachio-cubital fasciotomy resolves these stenoses successfully and allows complete angioplasty with vascular skeletonization and open revision if required.

Improvement of Renovascular Malignant Hypertension after Angioplasty

Malignant hypertension in young female with disparity in kidney size raise the attention toward non-essential renovascular hypertension. In this case we describe a young female suffered severe hypertension associated with deterioration of kidney function and disparity in kidney size by ultrasound. Hemodialysis was started because of electrolytes imbalance and fluid overload which is unusual with unilateral renal artery stenosis. Management by traditional antihypertensive medication was with limited benefit and patient condition required intensive care monitoring. Balloon dilatation angioplasty with stent insertion in the left renal artery was performed, blood pressure started to respond to anti-hypertensive medications but she became anuric. Daily hemodialysis session was done, after few days her condition started to improve and serum creatinine returned to normal base 1.1 mg/dl without dialysis support. The patient presentation was not classic toward either unilateral renal artery stenosis or reno-parenchymal disease.

Clinical analysis of patients with lower extremity deep venous thrombosis complicated with inferior vena cava thrombus

To explore the clinical profiles of patients with lower extremity deep venous thrombosis (DVT) complicated with inferior vena cava (IVC) thrombus and summarize their clinical diagnostic and therapeutic experiences. The clinical characteristics, diagnosis and treatment of 20 hospitalized patients with DVT complicated with inferior vena cava thrombus were analyzed retrospectively. All of them were of proximal DVT. There were phlegmasia cerulea dolens (n = 3), pulmonary embolism (n = 3) and completely occlusion of IVC (n = 5). Clinical manifestations were severe. Retrievable inferior vena cava filter (IVCF) was implanted for 17 cases. Catheter-directed thrombolysis (CDT) through ipsilateral popliteal vein was applied for 7 cases and systemic thrombolysis therapy for 8 cases. The effective rate of thrombolysis for fresh IVC thrombus was 100%. Among 5 cases with Cockett Syndrome, 3 cases underwent balloon dilatation angioplasty and endovascular stenting of iliac vein. And 17 IVCFs were retrieved successfully within 3 weeks. IVC thrombus disappeared completely in 15 cases. Systemic or local thrombolysis with protective IVCF is a safe and effective therapy for nonocclusive IVC thrombus in DVT. And CDT is recommended for symptomatic occlusive IVC thrombus.

Cerebral Vasospasm Following Subarachnoid Hemorrhage.

Cerebral vasospasm and related ischemic stroke continue to be significant complicating factors in the course of many patients with subarachnoid hemorrhage from berry aneurysm rupture. The risk of this well-recognized but poorly understood complication can be estimated on the basis of patient medical history, neurologic examination, and head CT findings. Every patient with possible risk needs specialized neurologic intensive care unit care after aneurysm obliteration. Surgical and pharmacologic wash-out of subarachnoid blood around the basal arteries, proper management of intracranial pressure and fluid status, hyponatremia, hypomagnesemia, and fever, as well as use of calcium channel blockers, have been considered helpful in patient management prior to and with the symptomatic vasospasm development. Transcranial Doppler (TCD) ultrasound is important in detecting vasospasm before the patient suffers ischemic neurologic deficit or infarct. Elevated TCD velocities often initiate the use of triple-H (HHH: hypertension, hemodilution, and hypervolemia) therapy and subsequently guide it. Up to the end of the first 3 weeks after subarachnoid hemorrhage and aneurysm obliteration, development of any focal neurologic deficit or mental deterioration, unless convincingly proven otherwise, is assumed to be from cerebral vasospasm. When a hemodynamically significant vasospasm in the arterial segments of clinical concern is suggested, emergency cerebral angiography with balloon dilatation angioplasty or intra-arterial infusion of vasodilating agents may be helpful in relieving ischemic symptoms.

Cell replication induces in-stent lesion growth in rabbit carotid artery with preexisting intimal hyperplasia

This study examined the responses of rabbit carotid artery with a preexisting intimal lesion, to stent implantation and balloon dilation. Rabbit carotid arteries were injured with a Fogarty catheter, and 28 days later the same arteries were subjected to implantation of a Palmaz-Schatz stent or balloon dilation angioplasty. Intimal size was significantly increased after stent implantation and balloon dilation, and no significant difference was detected between the two procedures. After stent implantation, replicating intimal cells were increased mainly in the inner intima, and the increase of cell replication was prolonged until day 28. In contrast, a significant increase of intimal cell replication was detected only at 2 days after balloon dilation. Intimal cell number after stent implantation was significantly higher than that after balloon dilation from day 7. Abundant leukocytes adhered to the luminal surface until 14 days after stent implantation, and significant infiltration of macrophages was observed in the mid-intima. Activation of proteases was prolonged, and obvious accumulation of proteoglycans was detected after stent implantation as compared with balloon dilation. These findings suggest that, an increase in cell replication is critical in the development of in-stent restenosis, and that inflammatory responses represent a unique property after stent implantation.

Balloon dilation angioplasty of peripheral pulmonary stenosis associated with Williams syndrome

Balloon dilation angioplasty of peripheral pulmonary stenosis associated with Williams syndrome

Balloon dilation angioplasty of peripheral pulmonary stenosis associated with Williams syndrome.

Experience of balloon dilation of peripheral pulmonary stenosis (PPS) in Williams syndrome (WS) is limited. Catheterizations in all patients with WS undergoing therapy for PPS from 1984 to 1999 were reviewed. Criteria for successful dilation included an increase >50% in predilation diameter and a decrease >20% in ratio of right ventricular (RV) to aortic (Ao) systolic pressure. Median age and weight were 1.5 years and 9.5 kg. There were 134 dilations during 39 procedures in 25 patients. The success rate for initial dilations was 51%. In multivariate analysis, successful dilation was more likely (1) in distal than in central pulmonary arteries (P=0.02), (2) if the balloon waist resolved with inflation (P=0.001), and (3) with larger balloon/stenosis ratio (P<0.001). RV pressure was unchanged after dilation (96+/-30 versus 97+/-31 mm Hg), primarily because of failure to enlarge central pulmonary arteries. The Ao pressure increased (102+/-14 versus 109+/-19 mm Hg, P=0.03), and the RV/Ao pressure ratio decreased (0.97+/-0.34 versus 0.91+/-0.30, P=0.05). Aneurysms developed after 24 dilations (18%) and were not related to balloon/stenosis ratio. Balloon rupture in 12 dilations produced an aneurysm in all 7 cases when rupture was in a hypoplastic segment. Three patients died, none from pulmonary artery trauma, and all before 1994. Mortality occurred early in our experience. Despite successful dilation of distal pulmonary arteries, there was modest initial hemodynamic improvement, mainly because of persistent central pulmonary artery obstruction. A serial approach of distal dilations followed by surgical repair of proximal obstruction may be a rational and successful therapy.

Balloon angioplasty for obstructed modified systemic-pulmonary artery shunts and pulmonary artery stenoses

OBJECTIVESThe results of percutaneous balloon angioplasty for obstructed modified Blalock-Taussig (BT) or central shunts and pulmonary artery (PA) stenoses were studied to assess its role as an alternative to second shunt and surgical PA angioplasty.BACKGROUNDObstruction of a modified shunt and PA stenosis related to the shunt or ductus are not infrequent. A second shunt with or without PA angioplasty is required if the PA size, morphology or age of the patient is suboptimal for definitive surgery.METHODSFrom June 1994 to May 1999, balloon angioplasty for obstructed systemic-to-PA shunts was performed in 46 patients, with ages ranging from 1 month to 7.4 years (2.2 ± 1.9 years). Among the 46 patients, 32 had modified BT shunts, 5 had bilateral shunts, 7 had modified central shunts, and 2 had both modified BT and central shunts. Stenoses were seen in 27 main branch PAs, and interruption was present in three. A concurrent balloon angioplasty was attempted in 28 main branch PAs, but it was performed in only 25 vessels.RESULTSBalloon dilation for obstructed modified shunts was considered to be effective in 42 patients (91%), while angioplasty for PA stenosis was effective in 14 vessels and not effective in 11 vessels. After balloon dilation angioplasty, oxygen saturation in the aorta increased from 74.4 ± 4.3% to 80.8 ± 3.6% (p < 0.01) in these 46 patients. One patient died of pneumonia. Eight patients required an additional modified BT shunt soon after the procedure because of severe stenosis or interruption at main branch PA. After a mean follow-up period of 11.6 ± 5.4 months, 29 patients underwent a repeated imaging study to evaluate the morphology and size of the PAs. Of these 29 patients, 26 underwent open-heart surgery, with two mortalities.CONCLUSIONSWhen a second shunt is under consideration because of obstruction of the modified shunt, balloon angioplasty is a possible alternative procedure. Pulmonary artery stenosis, if present, can be simultaneously dilated.

Treatment of cerebral vasospasm after subarachnoid haemorrhage: an update

Delayed ischaemic deficits induced by cerebral arterial vasospasm are the most common postbleed complications and are the most important causes of death and severe disability in patients with subarachnoid haemorrhage. In spite of extensive clinical and experimental investigations in recent years, the basic pathophysiology of cerebral arterial vasospasm after subarachnoid haemorrhage remains uncertain, and treatment modalities for symptomatic cerebral arterial vasospasm are controversial. Successful treatment has been achieved with a wide variety of drug and interventional regimens. However, few of these preventive and therapeutic strategies have been evaluated in prospective, randomized, controlled trials. The therapeutic approaches for delayed neurological complications due to cerebral vasospasm after subarachnoid haemorrhage include haemodynamic augmentation, balloon dilatation angioplasty, intra-aortic balloon counterpulsation, and the use of drugs such as calcium-channel blockers, antioxidants, thrombolytic agents, endothelin receptor antagonists and papaverine. In the absence of firm guidelines for the clinician about postoperative treatment strategies, a graded treatment protocol in which volume expansion and induced hypertension are the mainstays is presented.

Angioplastia de lesiones residuales tras cirugía correctora de transposición de grandes vasos

Surgical correction in infants born with transposition of the great arteries, venous rerouting procedure (Mustard or Senning operation) or an arterial switch operation, can be complicated by vascular narrowings. Balloon dilatation angioplasty may be the treatment for these stenotic lesions and is attempted to avoid a reoperation of these patients. Angioplasty was attempted in nine patients after the surgical correction of transposition of the great arteries. Senning procedure was performed in sixty-one patients; two patients (3.2%) were successfully balloon-dilated for systemic venous obstruction: superior vena caval obstruction (case 1) and inferior vena caval obstruction (case 2). Arterial switch operation was performed in forty patients, balloon angioplasty was attempted in seven patients (17.5%) who developed supravalvar pulmonary artery stenosis. Mean age at dilation was 32.5 +/- 20.7 months (range 11 to 67) in the switch arterial group. Age at dilation in the Senning group was 8 and 106 months. The balloon/stenosis diameter was 2 to 3 in the switch arterial operation and 3 to 8 in the Senning procedure. Balloon dilatation angioplasty was successful in three patients with supravalvar pulmonary stenosis postarterial switch operation (mean age was 16.6 months) and reduced the peak-to-peak gradient from 78.6 +/- 36.6 mmHg to 44 +/- 15 mmHg. There was no success after angioplasty in three patients and it was not possible to cross the stenosis with the guidewire in one (mean age was 46 months). Balloon dilatation angioplasty was successful in the obstruction following Senning procedure. These data indicate that although the success rate of balloon angioplasty for supravalvar pulmonary stenosis after the arterial switch operation is low, balloon angioplasty can be the first therapeutic choice owing to its low complication rate and the potential benefit of the procedure. The success rate should be higher if angioplasty is performed at a younger age after operating and a balloon of adequate size is used. Postoperative systemic venous obstructions can be successfully managed with balloon dilatation.

Effective management of cerebral vasospasm with balloon angioplasty after failed papaverine angioplasty

A 37 year old male with symptomatic cerebral vasospasm complicating the rupture of a basilar tip aneurysm was initially treated with intra-arterial papaverine in conjunction with concomitant hypervolaemia and induced hypertension. However, the vasospasm was only moderately improved, with this effect lasting for less than 24 h. Following further administration of intra-arterial papaverine, without significant angiographic improvement, endovascular balloon dilatation of both vertebral arteries and basilar artery resulted in dramatic and sustained reversal of angiographic vasospasm. The patient's clinical condition improved dramatically after this procedure, progressing from an unconscious state requiring ventilatory support, to a Glasgow Coma Score of 15 in the absence of focal neurological signs (with the exception of a right oculomotor palsy), within 9 days. This case suggests that there may be a role for balloon dilatation angioplasty, in patients who have cerebral vasospasm refractory to treatment with intra-arterial papaverine.

Use of the Internal Jugular Vein Approach in Balloon Dilatation Angioplasty of Pulmonary Artery Stenosis in Children

Use of the Internal Jugular Vein Approach in Balloon Dilatation Angioplasty of Pulmonary Artery Stenosis in Children

Intussusception of the catheter sheath: a nonemergency.

Percutaneous balloon dilatation angioplasty is a common therapeutic modality in patients with congenital heart disease. We report three cases of the catheter sheath telescoping into the hub of the sheath after removal of the balloon catheter. Although initially it appeared as though the sheath was torn, in actuality it was intact. We report this problem so others can avoid needless searching and concern for the "missing" catheter tip.

Prospective study on a new therapeutic strategy for infants and children with aortic coarctation

AbstractThere is little information on the indications for balloon dilation angioplasty for aortic coarctation. To determine the indications for balloon dilation in aortic coarctation, we evaluated prospectively the outcome of children treated according to our therapeutic protocol. The protocol included patients with postoperative recoarctation and isolated native coarctation with risks for surgical repair as conditions for which balloon intervention was absolutely indicated, and native coarctation without a significant arterial duct as a condition possibly qualifying for balloon dilation. Patients with duct-dependent coarctation and diffuse hypoplasia of the aortic arch were not considered to require balloon intervention and were treated surgically. We entered 47 patients into this protocol between January 1988 and December 1993. In 21, dilation was performed successfully and provided significant relief of pressure gradients. The peak systolic pressure gradients across the coarcted site in native coarctation and postoperative recoarctation decreased significantly from 40±19 to 13±10 mm Hg (p&lt;0.0001) and 38±24 to 14±75 mm Hg (p&lt;0.01) immediately after the procedure, respectively. Similarly, the diameters of the coarcted site increased significantly from 3.8±1.8 to 6.6±2.43 mm (p&lt;0.0001) and 4.6±1.9 to 6.0±2.0 mm (p&lt;0.005), respectively. Five patients with native coarctation, and one with postoperative recoarctation, developed restenosis during the period of follow-up and were treated successfully with repeat dilation. It may be possible to change the therapeutic strategy for aortic coarctation with advances in the use of balloon dilation. Our protocol for this technique appears to be reasonable, but further evaluation of its indications is needed.