Balloon angioplasty for uncontrollable hypertension caused by coral reef aorta: A case report


      Coral reef aorta is a stenosis of the aorta due to severe calcification. We report the case of a 74-year-old woman with coral reef aorta whose hemodynamics were physiologically similar to those found in patients with renovascular hypertension. The patient had resistant hypertension, refractory edema, and renal dysfunction. Bilateral renal artery stenosis and infrarenal aortic stenosis were suspected after a Doppler ultrasound examination. Evaluation by intravascular ultrasound and pressure wire revealed that the high blood flow caused by infrarenal aortic stenosis derived from the high-flow velocity in a renal artery without stenosis. Angioplasty with balloon improved the stenosis, and the patient was relieved from a spiral of uncontrollable hypertension, edema, and renal dysfunction. This rare case was a patient with coral reef aorta who was diagnosed with uncontrollable hypertension and angioplasty was performed effectively and minimally invasively.
      <Learning objective: Coral reef aorta should be considered as a diagnosis for patients suspected to have renovascular hypertension. Furthermore, angioplasty with balloon is an effective treatment approach.>


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        • Qvarfordt P.G.
        • Reilly L.M.
        • Sedwitz M.M.
        • Ehrenfeld W.K.
        • Stoney R.J.
        Coral reef" atherosclerosis of the suprarenal aorta: a unique clinical entity.
        J Vasc Surg. 1984; 1: 903-909
        • Grotemeyer D.
        • Pourhassan S.
        • Rehbein H.
        • Voiculescu A.
        • Reinecke P.
        • Sandmann W.
        The coral reef aorta - a single centre experience in 70 patients.
        Int J Angiol. 2007; 16: 98-105
        • Pranteda C.
        • Menna D.
        • Capoccia L.
        • Sirignano P.
        • Mansour W.
        • Speziale F.
        Simultaneous open surgical treatment of aortic coral reef and Leriche syndrome: case report and literature review.
        Ann Vasc Surg. 2016; 32: e1-e5
        • Gaggiano A.
        • Kasemi H.
        • Monti A.
        • Laurito A.
        • Maselli M.
        • Manzo P.
        • Quaglino S.
        • Tavolini V.
        Extra-anatomic revascularization of extensive coral reef aorta.
        Ann Vasc Surg. 2017; 44: e1-e7
        • Isoda R.
        • Morita I.
        • Mano M.
        • Ishida A.
        Balloon-expandable stent graft for coral reef aorta.
        J Vasc Surg Cases Innov Tech. 2020; 6: 422-424
        • Gatta E.
        • Berretta P.
        • Pagliariccio G.
        • Schiavon S.
        • Carbonari L.
        Emergency endovascular treatment of coral reef aorta with an unconventional technique.
        Ann Vasc Surg. 2020; 63: e5-e9
        • Vijayvergiya R.
        • Mohammed S.
        • Kanabar K.
        • Behera A.
        Treatment of symptomatic coral reef aorta by a nitinol self-expanding stent.
        BMJ Case Rep. 2019; 12e229179
        • Salcher M.
        • Naci H.
        • Law T.J.
        • Kuehne T.
        • Schubert S.
        • Kelm M.
        Balloon dilatation and stenting for aortic coarctation: a systematic review and meta-analysis.
        Circ Cardiovasc Interv. 2016; 9e003153