For coarctation of the aorta (CoA), lifelong imaging surveillance with MRI or CT is recommended — before and after intervention — per the 2022 ACC/AHA aortic disease guideline, and either endovascular stenting or open surgical repair is indicated for significant native or recurrent coarctation with hypertension. Catheter-based treatment with balloon-expandable stents has gained momentum as an alternative to surgery in adolescents and adults, with covered stents preferred for their lower risk of stent fracture and vascular injury (as emphasized in the 2024 EACTS/STS aortic guidelines). An important caveat from long-term registry data: although transcatheter intervention has a high procedural success rate and substantially reduces hypertension, many patients remain hypertensive and need ongoing antihypertensive therapy — so coarctation is best viewed as a lifelong cardiovascular condition, not a one-time fix.
Further reading: 2022 ACC/AHA aortic disease guideline (Isselbacher et al.); 2024 EACTS/STS aortic guidelines (Czerny et al.); Nordic registry of transcatheter intervention for CoA (Eriksson et al., JACC Cardiovascular Interventions 2023).