This protocol applies to coarctation of the aorta in patients who are normotensive (no hypertension) but have an increased non-invasive gradient confirmed by an invasive peak-to-peak gradient between the upper and lower limbs of more than 20 mmHg. The confirmed haemodynamic significance of the obstruction — even in the absence of hypertension — is the basis for intervention in this setting.
Endovascular treatment is the primary modality considered in this scenario when technically feasible. The complete protocol — specifying the preferred technique, the conditions under which surgical alternatives are indicated, and the full decision pathway — is available via the link below.