Original Article Morphometric evaluation of aortic coarctation and collateral circulation using computed tomography in the adult population Maciej Krupi  nski , Malgorzata Irzyk, Zbigniew Moczulski, Robert Bany s and Malgorzata Urba  nczyk-Zawadzka Abstract Background: Analysis of morphometric details of aortic coarctation and collateral circulation using computed tomog- raphy (CT) and its impact on clinical symptoms is a perspective which is missing in the published literature. Purpose: To perform CT-based qualitative and quantitative evaluation of aortic coarctation and collateral circulation with reference to clinical symptoms. Material and Methods: The study comprised 2022 patients who underwent CTangiography. If aortic coarctation was seen, the patients underwent evaluation of its anatomy and associated clinical symptoms. Results: Aortic coarctation was found in 33 patients. Follow-up (median 2476 days; range 1692–3543) was performed in 31 (94%) individuals. In this group (median age 42 years; range 30–52.5 years), median stenosis at the site of coarctation was 70% (range 58–85%) of the lumen area, with 17 (55%) patients presenting with significant (70%) stenosis. Patients with significant stenosis had a greater right and left internal mammary artery diameter (P ¼ 0.0070 and P ¼ 0.0114, respectively) than those with mild stenosis. Patients with significant coarctation stenosis revealed hyperten- sion and headache more commonly than those with mild stenosis (17 vs. 9, P ¼ 0.01 and 10 vs. 2, P ¼ 0.02), respectively. In patients who underwent intervention, a decrease in prevalence of hypertension (19 vs. 0, P ¼ 0.008) and headache (12 vs. 3, P ¼ 0.010) were observed in the follow-up. Conclusion: CTenables quantitative and qualitative evaluation of aortic coarctation anatomy, including stenosis at the site of coarctation, and collateral circulation. In adult patients with aortic coarctation, the prevalence of hypertension and headache is related to the degree of stenosis at the site of coarctation and decreases after intervention. Keywords Cardiac, computed tomography angiography, aorta, anatomy, congenital Date received: 2 March 2019; accepted: 23 July 2019 Introduction Aortic coarctation (CoA) occurs in 0.4% of live born neonates (1) and accounts for 6–8% of all congenital heart disease (CHD) (2). The majority (3) of CoA cases (82%) are isolated and are diagnosed in the neonatal period or early childhood (4) by symptoms of conges- tive heart failure or decreased pulse in the lower extremities (5). A small percentage of CoA remain undiagnosed until adulthood and is usually discovered due to evaluation of a heart murmur or presence of upper extremity hypertension (6). Imaging studies in adult patients with CoA reveal periductal aortic nar- rowing, commonly with coexisting bicuspid aortic valve (7), developed pre- and post-stenotic aortic dila- tation, and collateral circulation including greater Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland Corresponding author: Maciej Krupi nski, Department of Radiology and Diagnostic Imaging, John Paul II Hospital, ul. Pra ˛dnicka 80, 31-202 Krak ow, Poland. Email: maciej.krupinski@gmail.com Acta Radiologica 0(0) 1–8 ! The Foundation Acta Radiologica 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0284185119877328 journals.sagepub.com/home/acr