Percutaneous reconstruction of aortic isthmus atresia using coronary total occlusion technique.

Aortic isthmus atresia is an extreme form of coarctation presenting in adults and usually calls for surgical correction. In this report, we present our initial experience with the first four cases successfully treated percutaneously using dedicated coronary total occlusion wires and techniques. <Learning objective: This case series shows a technique to cross totally occluded coarctation using the coronary chronic total occlusion technique which has not been described in the literature till date. Further, these cases although not common are not as rare either as is evident by our experience of four consecutive cases observed over a period of 6 years in a large tertiary care centre. The readers could benefit from applying the same principles for similar cases that they would see in their clinical practice.>.