RE-INTERVENTION STRATEGIES FOR IN-STENT RESTENOSIS IN AORTIC COARCTATION: FOCUS ON BALLOON ANGIOPLASTY

In-stent restenosis (ISR) after repair of aortic coarctation presents an ongoing clinical challenge, with limited long-term data to guide management. We report the case of a young 29-year-old man who developed in-stent restenosis, six years after implantation of a covered stent for coarctation of thoracic aorta. He presented with resistant hypertension and lifestyle-limiting lower limb claudication pain. Subsequent management utilising imaging and endovascular intervention using sequential high-pressure balloon dilatations was done and re-expansion was the stent was achieved, with a marked reduction in gradients, and complete resolution of symptoms. This case underscores balloon angioplasty as an effective strategy for ISR in a previously placed covered stent, reaffirming its role in contemporary practice. Beyond the technical success, it highlights the importance of vigilant surveillance, timely recognition of restenosis, and an individualized approach with respect to re-intervention for better long-term results.