The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on balloon angioplasty with or without stenting for coarctation or recoarctation of the aorta in adults and children.
Aortic coarctation is a congenital narrowing of part of the aorta, most commonly the aortic arch, usually close to the origin of the left subclavian artery.
Balloon angioplasty of aortic coarctation is a minimally invasive procedure which involves inserting a catheter into a large blood vessel, usually in the groin, and passing it up to the area of narrowing under X-ray control. A balloon is then inflated within the narrowing. A stent (a small tube) may be placed within the narrowing to keep it dilated. Balloon angioplasty and stenting may be carried out as a first treatment (in 'native' coarctation) or if previous surgical or angioplastic treatment fails and coarctation recurs ('recoarctation').
The standard treatment for native and recurrent coarctation involves open chest surgery.