title: Successful percutaneous stent implantation for isolated dismal transverse aortic arch kinking.
abstract: BACKGROUND
  Isolated dismal transverse aortic arch kinking in adults is rare, and there is no recommended therapy at present. Percutaneous stent implantation may be an effective method to correct it and could be considered.
  
  
  METHODS
  We report a 46-year-old woman who suffered from recurrent migraine and refractory hypertension with a significant systolic blood pressure difference between upper limbs.
  
  
  METHODS
  The woman was diagnosed with isolated dismal transverse aortic arch kinking with refractory hypertension.
  
  
  METHODS
  Percutaneous stent implantation was performed. Due to the kinking nature of the diseased transverse aortic arch, the first covered stent moved forward to the proximal transverse aortic arch during deploying without the left common carotid artery occlusion. And then, a second stent was placed to cover the residual kinked part of the dismal transverse arch.
  
  
  RESULTS
  Angiography and post-procedural computed tomography angiography revealed fully corrected of the diseased segment. At 6-month follow-up after procedure, the patient was free of any symptoms and had a normal blood pressure under antihypertensive treatment.
  
  
  CONCLUSIONS
  This case indicates that transverse aortic arch kinking in isolation can be well treated by percutaneous stent implantation in adult patients. Unlike pure aortic coarctation, elongation and bucking give the rise to the occurrence rate of stent sliding and migration and sometimes a second stent is needed.
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Zhi-Liang
authors.initials: ZL
authors.lastname: Zuo
authors.forename: Jia-Yu
authors.initials: JY
authors.lastname: Tsauo
authors.forename: Mao
authors.initials: M
authors.lastname: Chen
authors.forename: Yuan
authors.initials: Y
authors.lastname: Feng
mesh_terms: D001018:Aortic Diseases / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008875:Middle Aged; D015607:Stents